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City <br />Zoning ~lidation <br /> <br />BUILDING [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~,e~a~r Bl~. No- 225 <br /> 229 High S'~t NE <br /> <br /> MOBILE HOME [] SEPTIC [] <br /> <br />City Setback Requireme~nt~ <br /> <br />Left Right <br />Side: ~ Side <br /> <br />PERMIT APPLICATION <br /> <br />Property C~mer <br /> <br />JOb Address' <br /> <br />--Mobile Hor~ Park: <br /> <br />Lot WKith <br /> <br />Township: <br />Lot D~:~th" <br /> <br />ph~e; <br /> <br /> 8itc No - <br /> <br />Mallin~ Address <br /> <br />Property Tax Lot <br /> <br />Zone. Map <br />I~reg. Lot r'~rner: <br /> <br />Fleet S/C Zone <br /> <br />Block <br /> <br />Total # <br /> <br />I.Contract~ Business Name and No.: <br /> <br />Type of Permit <br /> <br />Height of Building: <br /> <br />~V~bl~e Home' <br />Width: <br /> <br />' New; <br /> _~lter <br /> <br />[] Addition' [] De~ [~ Tech. <br />~ Relocation [] O¢c Chg., [] Review: [] <br /> <br /> No Stories. [ Sq, Ft. Main Floor Sq Ft. 2nd' FlOor: <br /> Mobile Home ~ Occupancy <br /> <br />Type of <br />Test Holes Read~,' <br />WILl cal!~hen holes ready: ~, proposed Bedrooms: <br />Existing Sep~Jc System <br /> Exlstin~ Tank, Size .,~ <br /> <br /> Date Tank PUreed <br /> <br />OTHER PERMIT~ REQUIRED BY TH~ DEP'E: PLUMBING, ECHA. NICAL, ELECTRICAL <br />MC tS~ <br /> <br />Use of Building RES ~_'J <br /> COM L~ <br /> <br />Sq. Ft. Garage Other <br />Occupe, nt Load,~- ' ~ Suppty:.\ <br /> <br />VaJuatlon, <br /> <br />Bldg Fee <br /> <br />Mobile Home Fee <br />Flee~ Surcharge; <br />Zoning Surcharge <br />State Surcharge- <br />plan~ Check Fee: <br />Site Evaluatlon Fee, <br />Septic Permit Fee~ <br />DEQ Surch&tge. <br />Technical Review Fee- <br />Reinspection Fee: <br />Irwesflgafiac Fee: <br />City Eee: <br /> <br />TOTAL FEE <br />RECEIPT NO. <br /> <br /> <br />