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1. JOB DESCRIPTION <br /> <br /> COMMIYlqITY DEVELOPMENT CENTER '~Y 6 1999 <br /> 3150 Lancaster Dr, NE - Suite C <br /> Salem, Oregon 97305 ~AR!~ C0[~,l~r <br />8:00 am - 4:30 pm 24 hr. Inspection Line 373-4427 I~4~]~$pEC].I[}i <br /> <br />( ) site Evaluation ( ) New Installation ( ) Alteration ( ) Repair ( ) Authorization ( ) Ex,ting gys~m R~port (for loan purposes) ( ) (3thor <br /> <br />UseofStmaure: iq~e~[~..r.~.~ No.~mployees: S~atingCapa~ity: Total#Existingmdrooms: ~.~ Total # Proposed Bedrooms: ,~ <br />2. LOCATION OF INSTALLATION <br /> <br />Subdivision: ~4AJ (..~t0~x.~ e~l{. Lot: q Block: [ { <br />Map:. Zone: (/..% Par0elSize:o'5~6--,A.~0) SF () AC UOB:t)Y () N <br />Prop : WaterSu~pply: ( ) Privale Wdl ( ) CortmmnityW~ll <br /> <br /> r INFORMATION <br /> <br />( ) I am the PROPERTY OWNER and own. r~side in. or will reside in the completed struatur~ and will be my own general contractor. <br /> <br />am the AUTHOIt IZg. O REPRESENTATIVE OF THE PROPERTY OWNER: <br />Business Name {please print): [~,~ [- ~n~; ~ ~. Iht' <br /> <br /> Mailing Address: ~"~ t 6 ~ t~lrl~t~-~ ~Lc[ ~ ~ <br /> Stree! C0y: <br /> <br />am a DEQ LICENSER INSTALLER: <br /> Business Name (please prim): <br /> <br />Mailing Address: <br /> <br />Zip: [ Phone: <br /> <br />License #: <br /> <br />4. FEES (Cirde t]~ Avv,,,p, hd~ Fee) <br />A. SITE EVALUATIONS <br />Site Evaluatiom R~sidentiaL lust lot $ 335.00 <br />Site Evaluation, Residential, ea addnl lot $ 205.00 <br />Site Evainatior~ ConunereiaL fwst 1000 gal $ 335.00 <br /> Site Evaluafior~ Conunereiak 1000-5000 gal $ 335.00 <br /> - $90/500galorpm't thereofabove 1000gal <br /> <br /> Site Evaluation. Rural Area Variance $ 335.00 <br /> <br /> CONSTRUCTION PERMITS, for the first 1000 gallo~s <br /> <br />City: Zip Phone: <br /> <br />AUTHORIZATION NOTICE <br />FieM Visit Required $ 250.00~ <br />No Fiald Visit Required $ 90.00 <br /> <br />ALTERATION PERMIT $ 400.00 <br /> <br />PERMIT RENEWAL <br />Field Visit Raodair e d $ ~00.00 <br /> <br />No Field Visit Required $ 85.00 <br /> <br />projected DSF; <br />Standard On-Site System $ 400.00 <br /> <br />Alternative System: <br /> Aerobic $ 400.00 <br /> Capping Fill $ 600.00 <br /> C~pool $ 400.00 <br /> Disposal Trench in Saprolite $ 400.00 <br /> Evapotr anspiration- Absorption $ 400.00 <br /> Gray Water Sump $ 20~.00 <br /> Pressure Distribution $ 600.00 <br /> Redundant $ 400.00 <br /> Sand Filter $ 750.00 <br /> Seepage Pit $ 400.00 <br /> Seepage Trench $ 400.00 <br /> St~ep Slope $ 400.00 <br /> Tile D~wale~ing $ 600.00 <br /> Pump or Dosing Siphon $ 25.00 <br /> <br />For more than 1000 gallons: $ 400.00 <br /> <br />REPAIR PERMIT <br />Single Family Dwelling, Major Repair <br />(Tank/Drainfield or Dminfield only) $ 200.00 <br /> <br />Single Family Dwelling, Minor Repair <br />(Tank only) $100.00 <br /> <br />Commercial Major Repair: See CONSTRUCTION <br />PERMITS for fee <br />Commercial Minor Repair $150.00 <br /> <br />ANNUAL EVALUATION <br /> Of an ALTERNATIVE SYSTEM $ 235.00 <br /> <br />+ $40/500 gal or part thereof above 1000 <br /> <br />B. COMMERCIAL PLAN REVIEW (cost of <br />-Plhn Review is included in permit for systen~ up <br />to 600 gallons) <br /> 600 gallons- 1000 gallons $135.00 <br /> 1000 gallons - 2500 gallons $135.00 <br /> thereof above 1000 gal <br /> <br />PUMPER TRUCK INSPECTION <br />First Vehicle. each inspection $ 80.00 <br />Each Additional Vehicle, <br />each inspection $ 45.00 <br /> <br />EXISTING SYSTEM EVAL $ 250.00 <br /> <br />RECORDS REVIEW $ 40.00 <br /> <br />~ [¢irde ore] MC15-81 Rev <br /> <br /> <br />