Laserfiche WebLink
Zoning Validation ~ux~ L"-/ 220 High Street NE <br /> <br /> MARION £OUN'~¥ <br /> B~¥~BIN~ ~a~E HOME <br /> <br />INSPECTION <br /> <br />Left~ ~ Right <br />LTM 'l <br /> Side ..~ / Side .~-/ <br /> <br />PERMIT APPLICATION <br /> <br />Property Owner <br /> <br />Job Address <br /> <br />Phone <br /> <br />Site No <br /> <br />Address <br /> <br />Property Tax Lot NO <br /> <br />Cross Street <br /> <br />Fleet S/C Zone:: <br /> 7 <br /> <br /> Subdivision <br /> <br /> I <br /> / Lot Depth <br />i L°tW , <br /> ....... <br /> <br />Sp # <br /> <br /> trreg <br />' A~res Lot:: L ~ ~/~'~'~'~ <br /> <br />Block ,_~ <br /> <br />Total # Spaces <br /> <br /> Typeof Permit I New ,~ Addition ~ Demo [] Tach <br />~~ ~-~- ' ~ I~[ ~ Alter <br />Height of Building Stories:: Sq Ft Main Floor:: I ~q 'Fi 2ed Floor <br /> <br /> Mobile Hom~ . ¢ Bedrooms:: I OccupanCy <br /> Mobile Home <br /> <br />Uae of Building:: <br /> <br />Sq Ft Garage <br />Occupant Load <br /> <br /> Valuation <br /> <br />RES Z~ <br />COM E~ <br /> <br />Other <br /> <br />Water Supply <br /> <br /> $ <br /> <br />Proposed Septic Installation <br />Previous Site Evaluation # <br />Type of System ~'~, ' ~ _~___ <br />Test Holes Ready:: <br /> <br />Will call when holes ready Proposed Bedrooms <br /> <br />Exieting Septic System <br /> Existing Tank Size <br /> Existing Drainfield Length:: <br /> Type of System <br /> <br />Da, t e_ T~,_a n.k. p~u_m2 .ed :: ................... E_xisting Bedrooms. , ........ <br /> <br />(~ I have read this application in its entirety and certify that the stated informaPon ts <br /> true and corre~ to the best of my kn~ledge <br />( ) I am performing ~rk on a prope~y ~ own or occupy <br />t ) I am a registered builder OR ( ) the authorized representative of a registered <br /> builder <br />~ The work w~l~ be performed by a registered builder <br />( J Other. <br />(~ I agree to build according to t~ubmiffed plans and specifications the laws of <br /> <br />OTHER PERMITS REQUIRED BY THIS DE~.; PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />R~ 12/87 <br /> <br />Bids Fee:: <br /> <br />Mobile Home Fee:: <br />Fleet Surcharge:: <br />Zoning Surcharge <br />State Surcharge:: <br />Plans Cheek 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 />i 05--.°° <br /> <br /> <br />