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i,y , ZJ?, <br />Zoning Validation <br /> <br />Dats i.J~-/~- ¢~ <br /> BUILDING [~MOBILE HOME [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Bldg. NO.. 225 <br /> <br /> SEPTIC [] <br /> <br /> City Setbac~k Requirements <br /> Front ~ Rear <br /> <br />lSide ~ Right <br /> Side <br /> <br />PERMIT APPLICATION <br /> <br />Property OwneL <br /> <br />Job Address <br /> <br />Sub~vis~o~ <br /> <br />Mobile Home ~rk:: <br /> <br />Phone <br /> <br />g Ad'cress;: ~ <br /> <br />Site NC <br /> <br />Property Tax Lot NO <br /> <br />LOt <br /> <br />Sp #:: <br /> <br />Cross Street <br /> <br />Zone <br /> <br />Block <br /> <br />Total ¢/' Spaces:: <br /> <br />Section:: <br /> <br />Lot Width <br /> <br />Township I Range <br />Lot Depth Acres:: <br /> <br />Zo~::~.¢. Map:: <br />Irrag L~ S. Corn~, <br /> <br />ContracJor Buai~:Less Name and NO' T Phone <br /> / <br /> <br />Address <br /> <br />Arcl~ct/Engineer , Phone:; Ad,df ess:: <br /> <br />Type of Permit' New:: I~ Addition:: <br />O/~,~ ~'~-e.6~¢~",/ Alter [] Relocation <br /> <br /> Mobile Home Mobile Home # Bedrooms:: <br /> Width:: Length;: <br /> <br />[] Demo:: [] Tach <br />L~ Ccc Chg [~ Review;: [] <br /> <br />Sq Ft, 2nd Floor <br /> <br />Occupancy <br /> <br />Use of Building RES ~'; <br /> <br />Sq ft Garage Other <br />Occupant Load water Supply <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation # <br /> Type of System <br /> <br />Test Holes Ready <br /> <br />Will call when holes ready:: Proposed Bedrooms <br />Existing Septic System <br />Existln9 Taok Size <br />Extsdo{~ Drainfield Length <br />__Type of System <br /> <br />Date Tank ~u,rftped <br /> <br />Existing Bedrooms <br /> <br /> I am a registered builder OR ( } the authorized representative of a registered <br /> <br /> Other <br /> I agree to build according to the submitted plans and specifications, the laws of <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PBMBING, MECHANICAL, ELE~RICAL <br /> <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 /> <br />City Fee:: <br /> <br />TOTAL FEE <br />RECEIPT NO <br /> <br /> <br />