Laserfiche WebLink
Zoning Validation; , <br />°ate; Y'/ 7 :' <br /> <br /> MARION COUNTY BUII~j~I(~II~P~I(~q IP I ~etPa~k Ra.921rements: <br /> <br /> o,.o. <br /> Phone 888~147 [ Sde; ~ Sde: O-- <br /> Code-A-Phon~ 4:30 RM. - <br /> <br />BUILDING ~ ~OB LE HO~E ~ <br /> <br />Property ~?ner: ~ r Phon~i Mailing Address: -- ~ ~- ¢~.,."~ ,..'t. <br /> <br />Job Address: Site NO.: Cross S_Street;// <br />~, ~ ~ ~¢~. Property Tax Lot No.; fii;e~S*O Zo <br />Subdivision; ~2 ~-~- ~. Lot: Block: <br />.I - r <br />Mobile Home ~rk'. Bp. ¢: ~ ~*~ :~* ~P~ <br /> <br />Sodom - TOwnship; Range; Zone; Map; <br />Lot Width; Lot Depth: / Acres'. Irreg. Lot:/~ Corner: <br /> <br />Contra¢tor Business Name and No,: ~ I Phone: I Address: <br />A~hiteEt/Engineer; p .~ / Phone; I Addre~8; <br /> <br />New; ~ Addition: [] Demo: [] Tach. <br />Alter: [Z) Relocation: [] Ccc. Chg,; [] Review: [] <br /> <br />Use of Building: <br /> <br />RES <br /> <br /> COM [] <br /> <br />Height of Building: No, Stories; Sq. Ft. 2nd Floor: Sq. Ft. Garage: Other: <br /> <br /> Sq, Ft, Main Floor: <br /> <br />Mobile Home # Bedrooms: Occupancy; <br />Length: (¢3 (,~ % ~ <br /> <br />Mobile Home <br /> <br />Proposed ~eptis Installation: <br />Previous Site Evaluation #: <br /> <br />Type of System: <br />Test Holes Read)/: <br />Will Call When holes ready: <br /> <br />Occupant Load; <br /> <br />Valuation: <br /> <br />Water Supply; <br /> <br /> $ <br /> <br />Existing Septic System: <br /> Tank Size; <br /> <br />Proposed Sedrooms; % <br /> <br />Type of System: <br />Date Tank Pumped: <br /> <br />Existing Bedrooms: <br /> <br /> I have read this appllaation in its entirety and cer~fly that the stated information i8 <br /> <br /> I am a registered builder OR ( ) the authorized repre8entatWe of a registered <br /> builder, <br /> <br /> ) Other <br /> ¢ I agree ta build aocordlng to the submi~ed plan8 and 8perfi~ati~the laws of <br /> <br /> ~HER PERMITS REQUIRED BY THIS D~.: PLUMBING, MECHANICAL, ELECTRICAL <br />' MO ~5~ <br /> <br />Bfdg, Fee: <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 Review Fee: <br />Reinspection Fee: <br />Investigation Fee; <br />City Fee: <br /> <br />TOTAL FEE: <br />RECEIPT NO.: <br /> <br /> <br />