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SFFE PLAN FOR PROPOSED DEVELOPMENT IN MARION COUNTY <br /> <br />~ol~rty Owner: ~_~'t ~,~e-?L, ?'ff,~,d~//2'~ <br /> <br />LOC Bl~k:. , Su~iv~ion: <br /> <br />I certify that the above <br />Applicant (Please Print) <br />Mailing Address: __ <br />Applicant's Signature: <br /> <br />PLANNING: <br /> <br />PUBLIC WORKS: <br /> <br />BUILDING INSPECTION: <br /> <br /> ,: . (~ ~-,e~r <br />Imowlexlge. <br /> <br />FOR OFFICE USE ONLY <br /> <br />Da~:-,, <br /> <br />Da~: <br /> <br /> <br />