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DEPT_ OF BUILDING INSPECTION <br /> Marion County <br /> <br />W, K, GRABER, BLDG, ADMINISTRATOR <br /> 3644401 Ext. 55. Courthouse <br /> <br />APPLICATION FOR BUILDING PERMIT <br /> <br />Permit No. <br />Valuation s _._Z']7 <br />Permit Fee s ~, ~ ____ <br />Septic Tank <br />Total Fee s <br /> <br />Application is mode to <br /> l~epair <br /> <br />Address ;,jh.~_ ~,.-g,.--~.'%- ~,..~~ <br />Lot % Black J ~ <br /> <br />Lot Size ~ <br /> <br />Const r¥¢Hon <br /> <br />Number of Storle~ <br /> <br />Occupancy or use <br /> <br />Sewage Disposal <br /> <br />Relocate Building <br />Demolish o Structure <br /> <br />Addition <br /> <br /> This perrnit covers Cogstruction <br />....... ..... © <br /> <br />Size of I~ldg, ~ C) ~'~ ~ ~ <br /> <br />Water Supply <br /> <br />Value et entire work when completed, i,ncluding labor and materiels: <br /> '~,~_~..,~.k,,~, ,tl,.. ~, , ~ ~ ~ ~ <br /> <br />Builder Address <br /> <br />Phone <br /> <br />Architect Address Phone <br /> <br />DESCRIPTION OF WORK <br /> <br />ONLY WORK DESCRIBED ABOVE INCLUDED IN PERMIT <br /> <br />Variance Case No ........... <br /> <br /> I agree.. ........ tO bLJiJd nccordina] to above description, p a ~s end spec CaAppllcan[)<~%~ '~/~~'J°ns end he Bud lg Code o Mar onCy <br /> <br /> APPLfCAT~ON RBCE~VED ';~P~C TANK ~~,M~N~RL/ ..... "~R~T ~S~'~~ ...... <br /> Approved-Not Approved ~pp~ove~-Not Approved <br /> <br />~_..:_~--:Z Z _ .z_ '-' . ...... <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPARTMENT: Heoti~g Plumbing <br /> <br /> <br />