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FOWO FIC USE ONLYI <br />Zoning Validat:O~'~.-~4~---~ I <br />Date: J/~ ~ ~ <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> <br /> MANUFACTURED ~U~B~I~P~ A .,~.~ E~/~ <br /> PERMIT APPLI~CATION <br />co~,~*r m a~ s~ca'io~s, rnrao~Jon 4 MARION COUNTY ~,.~--~ ~_~ <br /> <br />2. Localion of Instatlalion ,, 'f. O. t~ ~ z 7~ <br /> <br />Su~ih~i~ ; I ~ ~BI~ Urban Growth Bounda~? <br /> <br /> " Pfiva~W~ ( ) Sprhg ( ) <br />L~Widm,~ I~De~h/~D ,~ Acres Comer ~ <br /> <br />3. Con~act~ Infomation <br /> <br />( ) I un~nd ~at I must r~s~t as a oomtmcfi~ ~n~ac~ ff ~ s~ ~ sold or ~d for s~ b~om <br /> <br /> immodi~lely ~ot~y Marion County of the nam~ of <br /> <br /> ( ~m a m~st~md builder OR ~e au~d <br /> Au~d agen; °r"~asee: ~ : " d " ' <br /> <br /> 4. Feo Schedule <br /> A. (1) M~uhamd H~e ~ :;~ <br /> mMod~U~tma~q~e~ ~ $~=~ C. Addifimal~specfim <br /> ~) State Fee <br /> ~) State Su~e ~ ~ ~ D. ~vesfigaQ~ Fee <br /> <br /> B,(1) ~g,'d Stature S~mge Fee : <br /> <br /> (2) ~g.'d S~mm S~ge ~ew~ <br /> <br /> (3) ~ngSu~e(15.~ff~eable) ~ 15,~=_, ] , <br /> ; <br /> <br />Signature of Applicant: ~~ Date: <br /> <br /> <br />