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SITE PLAN FOR PROPOSED DEVELOPMENT IN MARION COUNTY <br /> <br /> / <br />Situs Address: ~ q 5~ ~ <br /> <br />Lot' Block: <br /> <br />Subdivision:, <br /> <br />Scale: <br /> <br />Drawn By: <br /> <br />I certify that the above information is accmate <br /> <br />MC: 15-60 <br />Rev. 11/91 <br /> <br />Applicant (Please Print) <br />Mailing Address: <br /> <br />Applicant's Signature: <br /> <br />PLANNING: <br /> <br />PUBLIC WORKS: <br /> <br />BUll,DING INSPECTION: <br /> <br /> to the best of my knowledge. <br /> <br />FOR OFF~CE USE ONLY <br /> <br />Dale: <br /> <br /> <br />