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City <br />Zomng Validation <br /> <br />Date <br /> <br />MARION COUNTY BUILDIN,.P~,NSPECTION I City Setback Requirements <br /> <br />BUILDING E~'/MOBILE HOME [] SEPTIC <br /> <br />Job Address <br /> <br />Subdivis:on <br /> <br />Mobile Home Park <br /> <br />Site No <br /> <br />Property Tax Lot NO <br />Lot <br /> <br />Sp # <br /> <br />Cross Stregt:: <br /> <br />Fleet S/C Zone <br /> <br /> Block <br /> <br />-To{a-~ ~. Spaces <br /> <br />Lot Width <br /> <br />Township~,~. Range::c.~..~ <br />Lot Depth Acres <br /> <br />Cora~/r <br /> <br />Contr ctor Business Name and NO <br />Architect,Engineer <br /> <br />Addition:: <br /> <br />Relocation <br /> <br />Height of Building <br /> /¥ <br />Mobile Home <br />Width <br /> <br />Proposed Septic Installation <br />Previous Site Evaluation <br /> <br />Type of System <br /> <br />Test Holes Ready <br /> <br />Will call when holes ready <br />Existing Septic System <br />Existing Tank Size <br /> <br />Exl$~i0g Oraictield Lengih <br /> <br />NO Stones Sq gt Main Floor Sq Ft 2nd Floor <br /> <br />Mobile Home [# Bedrooms [ Occupancy <br />Length L <br /> <br />Type of System <br /> <br />Date Tank Pumped <br /> <br />Proposed Bedrooms <br /> <br />Demo ~d Tach Use of Building ~ RES <br /> <br /> DOM <br />Ccc Chg : Review ~ A,,,;,;: J';lT~-,~g~z, Il <br /> Sq Ft Garage:: ~ Other <br /> ...... 5~u~t Load:: [ Water Supply:: <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.:: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev T2B7 <br /> <br />Valuation <br /> <br />Bldg flee <br /> <br />Mobile Home Fee:: <br />Fleet Surcharge <br />Zoning Surcharge <br />State Surcharge <br />Plans Check Fee <br />Site Evaluation Fee <br />Septic Permit Fee:: <br />DEQ Surcharge <br />Technical Revtew Fee <br />Reinspection Fee;: <br />Investigation Fee <br />City Fee <br /> <br />TOTAL FEE <br />RECEIPT NO :: <br /> <br />COG <br /> <br /> <br />