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Received By: <br /> <br />aty . <br />Zoning Validation: <br /> <br /> - I <br /> ~UILD~NG ~MOBLE HOME <br /> <br />MARION COUNTY BUILDfNG INSI~E~I'I~N~ ,~ / City Setback Requ' e e ts; <br /> <br />Job Address; <br /> <br />Subdivision <br /> <br />Mobile Home Park: <br /> <br />SEPTIC <br /> <br />Sectlon;,~,~_. Tov?: <br />Lot Width: Lot Depth; <br /> <br />Range:. <br /> <br />Acres; <br /> <br />Irreg:'"'"Lot: Cor:?¢ <br /> <br />Ii <br /> <br />[~rohltect/En~iaeer: ' -- <br /> <br />Ph4~e; <br /> <br />Phone: <br /> <br />Type of Permit: <br /> <br />Height of Building: <br /> <br />Mobile Home <br />Width'. <br /> <br />New: <br /> <br />Alter; <br /> <br />Addition: ~ Demo; L~ Tach, <br />Relocation: [] Oct. Chg.; ~ Review; <br /> <br />NO, Stories: <br /> / <br /> <br />Mobile Home <br />Length; <br /> <br />Sq. Ft. Main Floor: <br /> <br />Bedrooms; <br /> <br />Sq. Fl, 2nd Floor: <br />Occupancy; <br /> <br />Proposed Septic Irpetallation: <br />Previous Site Evaluation <br /> Type of System: <br /> Test Holes Ready: <br /> Will call when holes ready: <br /> <br />Existing Septic System: <br />Existing Tank Size; <br /> <br />Pro~csed Bedrooms: <br /> <br />Existing Dr~infield Lan{]!h: <br />Type of, System: <br /> <br />Date Tank pumps.d; <br /> <br />Existing Bedrooms; <br /> <br /> the st,rCa c40rs(~of~ a~d t~hefrdlnances~_ <br />SIGNATURE OF APPLICANT:~., / I ~ -.~ <br /> <br />Use of Building: ...... ]' RES <br />Sq, Ft. Garage; Other: <br /> <br />Occupant Load; <br /> <br />tWater Supply: <br /> <br />Mobile Home Fee: ...... <br /> <br />Fleet Surcharge; <br /> <br />ZoeJng Surcharge; <br />State Surcharge: /4Z /7t'5~ <br /> <br />Site Evaluation Fee; <br /> <br />Septic Permit Fee: <br /> <br />DEQ Surcharge; <br /> <br />Technical Review Fee: <br /> <br />Reinspect~on Fee: <br /> <br />Investigation Fee: <br /> <br />TOTA' EE; p05:_% <br /> <br /> <br />