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FOR OFFICE USE ONLY <br />Zoning Validation <br /> <br />MARION cOLrNTY BLll'LDING INSPECTION <br /> ~lcm. OR~$O1 <br /> <br /> 4:30 pm Y'~0I~ ~8S*$147 <br />Co~c-A-Plmne <br /> <br />SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br /> <br /> Commeremi ~ - Daily Sewa~ FI0w'~ <br /> _._s.i%Ev=l~on, ti~ looo 8,I~,Di~' F :~45,00, <br /> <br /> Gm W~rW eD[ ~1~ 1~0,~ 10.o0 <br /> ~olding Ta~k 2{~.~ 10.~ ..... <br /> P~U~ I~fn~UtlOfl }50.~ <br /> k~ undim lvl~m ~5,~" ':' J0,0~ <br /> <br />~pa~ T~,~¢b ........ Z4~-~ 10.~ .... <br />~ ~ ~yi~ ,,, <br /> <br /> · (~or eac~ ~difional 5~1. DSF ~,00 <br /> Au~od~o~ ~o~i~ ~M v~0 1~0.~ 10.00 <br /> Au~o~t,o~ N~i~ ~o ~ Vi~it~ .,_ 86.~ 10~ .... <br /> <br />( ) l will eau wl~en 'Fca Ho~s Dug <br /> <br />( ) [ am a mgi~rod buildcr or ( ) lh~ au~hOItized mpmseutaiive <br /> <br />Si~ ~valu~o~, ~ IoL ::~,Stoo ~o.oo <br />~i~g Fill 415,~ ,,,!0,~ ..... <br />Ho~iu~T~k : "' ~5:oo lo.O0 <br /> <br />~dugdanl ...... 245,~ 10.00 ...... <br /> <br />~p~ Trench 245,00 10.~ <br />A?air. ~a~!,,f~), ' , ?5.00 ~o,~ <br />Qon ~ion Pe~it R~ne~l (~o ~Jdd Visit) 85.~ 10.00 ..... <br /> <br />I o ' in c ' Aecdpt No,. <br /> <br />NAME OF APPLICANT (please print): <br /> <br />SIGNATURE OF APPLICANT: DATE,: <br /> <br />MC 15-SI REV 2/93 <br /> <br /> <br />