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• 1711 J.1L11111'Vl%11�V1 V.7L•L 1Ui.711131111AL L1•+•1•+LVl lVllil1 l �J.f -0089(80--DYr <br /> Site Address: ii �UnS,c-�' -2.4cA S . �,�19,,1� r9E-cE[iv-E -1Township R- Range y-V)• Section I L1 Tax Lot(9{W IZo Total Acres 5,(�-( <br /> Subdivision t . Block Lot DEC 1 2 2019 <br /> ❑ Drawn to Scale: Not Drawn to Scale -OR- 1 square= feet " MARION COUNTY <br /> B1°ILDINC INSrECTION <br /> 2P,2%. - y l <br /> • L-1 - ,),- i .1_ I -) >, i <br /> . .. .. .. .. .. .. .. .. .. .. . . . ./ . , <br /> . ..,--i-z3;q0,64_,- D kf --• , . . . . (-7 /74'1 <br /> . . . . . .\-�{,dub . . . . . . - - - - . . . <br /> - . . . . . . . . . A . . . . . . . . . . . . . <br /> . r`. . . . W'z..kl . . 1-X.41. . . . . . _ . . . . . . . _ . . . . <br /> • <br /> X44-►v : . . . . . . . . F - -1 - L E . . <br /> . . . . . . . . . .A . . . ,. . . . . . . . . . . . . . . . .i <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i 7.-Igykl <br /> 1 <br /> I certify that the above information is accurate to the best of my knowledge.I AM THE Owner or[ 1 Authorized Agent. <br /> NAME(please print)-:: _ - r� 2 <br /> P ) ..�-��\ c�+r�-�"'t�l'�Ol���� Telephone • Jr(�3, ��,t��:�' ('9 <br /> Applicant's Signature: � `� \ Date: ; — k D--1 <br /> Applicant's Mailing Address: . 12 24,, J U 11$e--fr1 I t(tit- i&i S . <br /> City: t \ D <br /> ZiP: �� Applicant's email: U� )���G ` r <br /> \�l\ ' _ • \ <br /> bf <br />