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Z <br /> <br />I. LoI:~ Block: <br /> <br />SITE PLAN FOR PROPOSED DEVELOPMENT 1N MARION COUNTY <br /> <br /> Map: <br /> <br /> T Range: <br />Subdivision: No. Acres: L~ <br /> <br /> Scale: I ,'t_._ ~O' DrawnBy: \,VA YNiS VAN <br /> I certify that the above information is accurate to the best of my knowledge. <br /> <br /> Applicant (Please Print) ~ - Phone: <br /> Mailing Address: I ?x , ~ , L{ ' 0o'2. <br /> Applicant's Signature: ~ ' '' ' Date: ~ <br /> FOR OFFICE USE ONLY <br /> PLANNING: ~ Dam: <br /> PUBLIC WORKS: Dale: <br />MC: 15-60 BUILDING INSPECTION: Dale: <br />Rev. 11/91 <br /> <br /> <br />