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Reeeived By-: ~ <br />City /'~ ¢' " <br />Zoning Validation: ~ <br /> <br />Da e .... <br /> <br /> BUILDING [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. NO, 225 <br /> <br /> Code-A-Phone 4:~10 RM. - 8;00 A.M. <br /> <br /> MOBILE HOME [] SEPTIC [~. <br /> <br /> I Oity Se,,tbac~k R~equirem~e.n_ts <br /> <br /> F,ont: r Bear: <br /> Left '~/' Right <br />PERMIT APPLICATION <br /> <br />Proper,~y Owner: ,~, [ Phone: Mailing Address: . <br /> <br />%b ~ddress: ...... F'S~Te No.: Cross <br /> <br /> ~. '~ ~n ~/~ / Prope~y Tax Lot No.: ~ I FleetS/C <br /> <br /> Section: / To~nship~.~ ~.1 Ra,ge: ~.- Zone~/~..._ M,p; j <br />'~' ~" [~¢ ~'~'~; / Acres;. ~"~ ..... ~'~'~. ~t: ...... Comer:~/ .. <br /> <br />Total # Spaces: <br /> <br />F Cgntractor Business Name and NO.; T Phone: <br /> / <br />Architect/Engineer; Phone: <br /> <br />Typ~ ,of Permit; <br /> <br />H(~lgh't of Building: ! / No, Stories: <br />Mobile Home Mobile Home <br />Width: Length: <br /> <br />New: [] Addition: [] Demo: [] Tach, <br />Alter: [] Relocation: [] Ccc. Chg.: [] Review: [] <br /> <br />Sq, Ft, Main Floor: <br /> '/o7' <br /> Bedrooms; <br /> <br />Sq, Ft. 2nd Floor; <br /> <br />Occupancy: <br /> <br />RES (~ <br /> <br />COM ['1 <br /> <br />Sq. Ft. Garage: Other; <br />Occupant Load; Water Supply: <br /> <br />Proposed Septic installation: <br /> Previous Bite Evaluation ¢; <br /> Type of System; <br /> <br />Test Holes Ready: <br />Will call when holes ready: <br /> <br />Proposed Bedrooms; <br /> <br />Existing Septic System: <br />Existing Tan_k. Size; <br />Existing Drainfield Length; <br />Type of Syst_e.¢n: ¢~.__~'.¢.-~,.__~_~¢.~ <br /> Date 'lank Pumped'. ;'~,¢ <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT,: PLUMBING, MECHANICAL. ELECTRICAL <br /> <br />Valuation: $ <br /> <br />Bldg, Fee; $ <br />Mobile Home ~=~e; <br /> <br />Zoning Surcharge: ..... <br />State Surcharge: ........ <br />Plans Check Fee; <br />Site Evaluation Fee: <br />Septic Permit Fee: <br /> <br />TOTAL FEE: ~- <br /> <br /> <br />