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eeeived, By <br /> .... MARION COUNTY BUILDING INSPECTION Fcity Se!b.~¢k R.e_quirements <br />City ' Senator Bldg No. 22g <br />z'R"oning VsliOafion <br /> '~g High StreM NE <br /> <br />Date:: /~-~ ~ ' ¢ ~ Phone 588-514~ [ Side ~ ~ Side <br /> SEPTIC <br /> <br />PERMIT APPBCATiON <br /> <br />Proper~ Owner:: <br /> <br />.~.¢Ldivision ~ <br /> <br /> Moiling Address ~,__ ............. <br /> <br />Property Tax Lot NO ~leet s/c Zone <br />Lot 3 Block ~ <br />Sp ¢ Total ¢ Spaces <br /> <br />Mobile Home Park <br /> <br /> Map <br /> <br />Township <br /> <br />Lot Depth <br /> /~ <br /> <br />ca~,ne~, <br /> <br />Lot Width <br /> <br />Arshitelc, t/Engineer Phone <br /> <br />Address <br /> <br />Address <br /> <br />Type of Permit;: <br /> <br />Height of Building <br /> <br />Mobile Homo <br />Width <br /> <br />New:: Addition [] Demo [~ Tach <br />Alter:: [] Relocation ~ Ccc, Chg:: LJ Review <br /> <br />No Stories:: <br /> / <br /> <br />Sq Ft Main Floor <br /> <br />Bedrooms:: <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation ~¢:: <br /> <br />Mobile Hame <br />Length <br /> <br />Type of System <br />Test Holes Ready:: <br />Will call when holes ready Proposed Bedrooms:: <br /> <br /> Existing Septic System <br /> Exis!jng_Tank Size <br /> Existing Drainfield I:_engt h:: <br /> Type of System:: <br /> Date Tank Pumped Existing Bedrooms <br /> <br />t / ~1 have read this application in its entirety and certify that ~he stated in foliation is <br /> true and Correct to tho best of my knowledge <br />( ,~,'~ I~rn performing work on a property I own er OCCUpy <br />( /~4,-~1 am a registered builder OR ) he au bo Zed ep eson a ye o a eg s e ed <br /> builder <br /> ) The work will be performed by a registered builder <br /> <br />OTHER PERMITS REQUIRED BY TRI0 DEFT,: Fi.I.IMBING, MECHANICAL, ELECTRICAL <br />MC ~5-6 <br /> <br />Sq Ft 2nd Floor Sq Ft Garage <br />Occupancy Occupant Load;: <br /> Valuation <br /> <br /> Bldg Fee <br /> <br /> Mobile Home Fee <br /> Fleet Surcharge:; <br /> Zoning Surcharge <br /> State Surcharge <br /> Plans Check Fee;: <br /> Site Evaluation Fee <br /> Septic Permit Fee:: <br /> DEQ Surcharge <br /> Technical Review Fee <br /> Reinspection Fee:: <br /> Investigation Fee <br /> City Fee <br /> <br /> TOTAL FEE <br /> RECEIPT NO <br /> <br />Use of Building:: . J RES ~ <br /> iQ F,...ly__. I eom <br /> Other <br /> <br /> Wat S, upply <br /> <br /> <br />