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Type of Building <br />/¢~lass of Building L <br /> <br /> DEPT. OF BUILDING INSPECTION <br /> Marion County <br /> <br />W,, K,, GRABER, BLDG ADMINISTRATOR <br /> 364-4401 E×t 55, CourthouSe <br /> <br />APPLICATION FOR BUILDING PERMIT <br /> <br />Permit No <br />Valuation s <br />Permit Fe~ <br />Sept;c Tank <br />Total Fee s <br /> <br />  Relocate <br />Apphcotion is made to Demolish <br /> Repair <br /> <br />Address .~ (~)' /¢J~':~X '~/~'~ ~.~ //O .~0~ <br /> <br />Lot /~ Bloc~ / ~ Addition /~ ~. <br /> <br />Construction <br /> <br />This percqit covers <br /> <br /> .... <br /> <br />Number of Stories / Basement /J,/~,~/L~ Height in feet ,/-~- <br /> <br />Sewage Disposal ~ ~~Water Supply <br /> <br />Value o~ e~fire work when compJeted including labor and materials s <br /> <br />O, IT"(' <br /> <br />4~wner .~ e~:,¢:~.-7'' ,~ (~4l..~.,.)z K!~-.Add,ess ~,,0, /~X 4//~, <br /> <br /> Buih:~er ~,4~,/~ L~ Address / <br /> <br />Aicl~itect '~'~/~,J~ '~ Address <br /> <br />Phone ......... <br /> <br />Phone <br /> <br />ON'V WORK DESCRIBED A OVE C,UDED RER T <br /> <br />DESCRIPTION OF WORK <br /> <br />Variance Case No <br /> <br />I agree to build according to aba'~e description: plans and specificotlons and the Building C~ode of Morion Count~ <br /> Applicant ~~.~",~- ~ <br /> <br /> APPLICATION RECEIVED SEPTIC TANK <br />/~,· f J Apgl oved- Not Agg~oCed <br /> <br />O[~E~ EER~If~ [E~UI[EO BY T~I[ DEPARTMENT:: Heating <br /> <br /> PLAN EXAMINER <br />Plumbing <br /> <br /> PERMIT ISSUED <br /> <br />Date -,-~'~ "z'~4' 7~ <br /> <br /> <br />