Laserfiche WebLink
Lont~g .By: /q~ Cay :. ~T'~/-fgh'~ [~ I' ~J]]l Salem, oregon 97305 <br /> ........... ~ - hS:t~ba~.~,~5m 24hr. Inspect~on Line 373-4427 FAX588-7948 <br /> MARION COUNTgN..SrrE SEWAGE DISPOSAL APPLICATION <br />1. JOBOESCRIPTION BIIll BI~ !~JSPECT~9,~ <br /> ( ) Site Evaluatinn ( ) New Installation ~.Alteratinn ()Repair ( ) Authofiza~on ( ) Existing System Raport (for loan purposes) () Othor I <br /> Use of Structere: ~/ No, Employees: Seating Capacity: Total# Existing Bedrooms: 3 Total # Proposed Bedrooms:3 <br /> I <br /> <br />3. APPLICANT INFORMATION <br /> <br /> ~am the PROPERTY OWNER and own, reside in. or will reside in the corapleted structure and will be my own general contractor. <br /> ( ) I am the AUTHORIZED REPRESENTATIVE OF THE PROPERTY ov+qNER: Business Nmaae (please print): <br /> <br /> Mailing Address: <br /> Street City: Zip: Phone: <br /> <br />~I am a DEQ INSTALL~E~: <br /> LICENSED <br /> <br />Stre~ <br /> <br />4. FEES (Circle ~he Appropriate Fee) <br /> <br />A. SITE EVALUATIONS <br />Site Evaluation, Residential, first lot $ 335.00 <br />Site Evaluatio~ Residential, ea addnl Icl $ 205.00 <br />Site Evaluation, Commercial, first 1000 gal $ 335,00 <br />Site Evaluation. Commercial, 1000-5000 gal $ 335.00 <br /> + $90/500galorpart thereofabovel000gal <br /> <br />Site Evaluation. Rural Area Variance $ 335.00 <br /> <br />CONSTRUCTION PERMITS. for the fast 1000 gallons <br />projected DSF; <br /> <br />AUTHORIZATION NOTICE <br />Field Visit Required $ 250.00 <br />No Field Visit Required $ 90.00 <br /> <br />ALTERATION PERMIT $ 400.00 <br /> <br />PERMIT RENEWAL <br />Field Visit Required $ 200.00 <br /> <br />No Field Visit Required $ 85.00 <br /> <br />B. COMMERCIAL PLAN REVIEW (cost of <br />Plan Review is included in permit for systems 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 INSPECT~i~4 <br />First Vehicle, each inspe " $ 80.00 <br />Each Additinnal Veh ¢ ~i~P~,. <br /> <br />Standard On-Site System <br /> <br /> $ 400.00 <br /> <br />Altemetive System: <br /> Aerobic $ 400.00 <br /> Capping Fill $ 600/00 <br /> Cesspool $ 400.00 <br /> Disposal Trench in Saprolile $ 400.00 <br /> Evap orr aaspiration-Abs oxl~tion $ 400.00 <br /> Gray Water Sump $ 200.00 <br /> Pressure Distribution $ 600.00 <br /> Redundant $ 400.00 <br /> S~md Fitter $ 750.00 <br /> <br />REPAIR PER~HT <br />Single Family Dwelling, Major Repa r <br /> (Tank/Drainfield or Dralnfield only) <br /> <br />$ 200.00 <br /> <br />$100.00 <br /> <br /> each inspection ~ " $ 45.00 <br />EXISTING Z~ ~V~ $250.00 <br />RECORDS I~VIEW $ 40.00 <br /> <br />FEE TOTALS: <br /> <br />Seepage Pit $ 400.00 <br />Seepage Trench $ 400.00 <br />Steep Slope $ 400.00 <br />Tile Dewetcrthg $ 600.00 <br />Pmnp or Dosing Siphon $ 25.00 <br /> <br />For more than 1000 gallons: $ 400.00 <br />+ $40/500 gal or part thereof above 1000 <br /> <br />Single Family Dwelling, Iffdnor Repair <br />(Tank only) <br /> <br />Commercial, Major Repair: See CONSTRUCTION <br /> <br /> $150.00 <br /> <br />PERMITS for fee <br />Commercial Minor Repair <br /> <br />ANNUAL EVALUATION <br /> Ofa~ ALTERNATIVE SYSTEM <br /> <br />$ 235.00 <br /> <br />Al. Enter Total Fees from Section 4A <br />A2. Add DEQ Surcharge(S30.00) <br /> for each item marked in <br /> <br />Signa~u'e of Apl~icant: ~ <br />Test Holes Ready: ~ Z --' <br />Cel'~flca~on at~ached? Y / N [circle one] <br /> <br /> o ' <br /> Sul~amd: <br />B. Enter Total n 4B $ <br />C. Reinspoctinn Fee, $50.0/hour $ <br />D. Hourly Inspection Rate, $50.00/hour $ <br /> <br /> <br />