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J~ MARION COU~ITY,,~U~L01NG INSPECTION <br />C,ry - , 2,, <br />Zoning Validation;~)v ~ 0 ?" ~ ;~ ~'~0 High ~ NE <br /> <br /> BUiLDiNG <br /> <br />Sde; ~ <br /> <br />Property <br /> <br />BUILDING [] MOBILE HOME [] <br /> Phone: <br /> <br />Subdivision; <br /> <br />SEPTIC [] PERMIT APPLICATION <br /> Mailing Address: <br /> <br />Site NO,; <br /> <br />Proper~y Tax Lot No,: <br /> <br />Mobile Home Park: Sp, <br /> <br />Cross Street!:,, <br /> <br />Block: <br /> <br />Total ~ Spaces: <br /> <br />Lot Width: Lot Depth: Acres: Corner: <br />/Od r <br /> <br />Contractor Business Name and No,: Phone: Address: <br />Architect/Engineer: . Phone: Address; <br /> <br />Type of Permit: New: <br /> <br />Height of Suilding. L,~-- <br /> <br />Mobile Home <br />Width: --' <br /> <br /> / <br /> <br />· ~ Addition; '~ Demo: [] Tach. <br />[] Relocation; r~ Ccc. Chg.: [] Review; [] <br /> <br />NO. Stories: <br /> / <br /> <br />Mobile Home <br />Length; ~- <br /> <br />Sq. Ft. Main, Floor: <br /># Sodrooms: <br /> <br />Sq. Ft, end Floor: <br /> <br />Occupancy: <br /> <br />U~ RES <br /> COM [] <br />8q, ~rage~." Other_~._ <br /> <br />Occupant Load: <br /> <br />Proposed Septic Installation: <br /> Previous Site Evaluation #; <br /> Type of System~ <br /> <br /> Test Holes Ready: <br />Will call when holes ready: <br />Existing Septic System: <br />Existing Tank Size: ;~.5,-- <br />Existing Drainfield <br /> <br /> Type of System: <br /> <br />Proposed Bedrooms; <br /> <br />Date Tank Pumped: Bedrooms; <br /> <br /> Ibavereadtbisapplicationinitsentimtyandcerdfythattheatatedinformat[onls <br /> true and correct to the best of my knowledge. <br /> I ~rn performing work on a property I own or occupy, <br /> I am a registered builder OR ( ) the authorized representative of a registered <br /> builder· <br /> ) The work will be performed by a registered bullde~ <br /> <br />~.~ Other <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br /> <br />Valuation: <br /> <br />Mob e ~on3eFee . · <br /> <br />Zoning Surcharge; <br /> <br />State Surcharge: <br /> <br />Plans Cheek Fee: <br /> <br />Site Evaluation Fee: <br /> <br />Septic Perm t Fee <br /> <br />DEQ Surcharge: ~ <br /> <br />Technical Review Fee; <br /> <br />Reinspectioh Fee: <br /> <br />Investigation Fee; <br /> <br />City Fee: <br /> <br />TOTAL FEE: ' <br /> <br /> <br />