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~ircj Va,idation <br /> <br />Home I~arR <br /> <br /> MARION COUNTY BUILDING iNSPECTION c~ Setba,,c_k Rrqulremanm-- <br /> ~ ~h m~.~ L ' / <br /> ~1~, O~n ~7~ [Left Right <br /> <br />BUILDING ~ MO~ILE HOME ~ SEP~C ~RMIT APPLICATION <br /> <br /> ~ite NO- <br /> <br />Property Tax Lot No <br /> <br />Lot:: <br /> <br />Me, p .... <br /> <br />C~ner;; <br /> <br />Flee1 S/C Zone <br /> <br />Total # Spaces <br /> <br />Contractor Busineas Name And NO "..-~2~-.2 7 ¢1~- Phone, <br />.(x~. ,t;¢~ ~--~,~ji~' Phone. <br /> <br /> .¢ype of Permit t New E3 Addition' [~ Demo: [] Te~h <br /> <br />~¢ of 8uiMing No S~rie¢ ~Sq Ft M~in FIo~ ~ Ft 2nd F~r: <br /> <br />LI~ of ~uilding ~ ~ 3 <br /> <br />Sq" ~t Garage Other <br /> <br />COM ¢~ <br /> <br />V~luaaon $. <br /> <br />Pre~,ious Site Evaluation ¢ <br /> <br />Te~',t Roles Read)F <br />Will Cell when holes ready_ <br /> <br />~ ExiSting l~nk Siz~ <br /> Existing Drainfield Le?~th' <br /> Type. of Syslem <br />_ Dante Tank ,%L_mped <br /> <br />Propo~d Bedrooms ~'~ <br /> <br />OTHER PIERt~ITS REOUIRED BY THI~ DEPT~; PLUMBING, M~E~:HANICAL~ ~=LECTRICAL <br />MC 15,6 <br />Rea 12,87 <br /> <br />Bldg Fee <br /> <br />Nk)bile Home Fee <br /> <br />State Surcharge- <br />Plar~e Check Fee:, <br /> <br />Sept~ Permit Fee <br />DEQ Surcharge <br /> <br />R~ns~n <br /> <br />City Fee: <br /> <br />TOTAL <br /> <br />RECEIPT NO <br /> <br />.... <br /> <br /> <br />