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Received By ~' <br />Zoning Validation <br /> <br /> MARION COUNTY BUiLDIICI~jN~EDT'E)U _ [-City Setback Require <br /> , <br /> <br />BUILDING ~ * ~ION¢~LICATI <br /> MOBILE HOME ~ SEPT~/~~ ON <br /> <br />Pr ope r_~..v. Owner Phone Mailing <br />Job Addre~ <br /> <br />Subdivision <br /> <br />Property Tax Lot No, <br /> <br />~ct <br /> <br />Block <br /> <br /> Total # Spaces::? <br />Mobile Home Park Sp ~:: //~ ~*,~[ ~ <br /> <br />, Range:: <br /> Acres <br /> <br />Section Township <br /> <br />Lot Width:: Lot Depth <br />~5',,01 <br /> <br />Zan~,~ Map __ <br />Irre/~;t:; ._Corn,¢~ ~) <br /> <br />Contractor Business Name and No,, <br /> <br />Architej~t/Engineer -- ~" <br /> <br />Phone:: ,J <br /> <br />,/.gpe of Permit <br /> <br />Height of Building:: <br /> <br />Mobile Home <br />Width <br /> <br />Alter <br /> <br />[~¢~-' A~ditlon:: F'I Demo:: <br /> <br />Fl Relocation F1 DOC Chg <br /> <br />"No Stories:: Bq Ft Main Floor <br /> <br /> Mobile Home # Bedrooms <br /> Length:; <br /> <br />[] Tach <br /> <br />[] Review FI <br /> <br />Sq Ft 2nd Floor <br /> <br />Occupancy <br /> <br />Use of Building <br /> <br />Sq Ft Garage <br />Occupant Load <br /> <br />RES <br />COM <br /> <br />Other <br /> <br />Proposed Septic Installation <br />Previous Site Evaluatioa # <br /> <br />'B,/pe of System:: <br />Test Holes Ready:: <br /> <br />Will call when holes ready <br /> <br />Bxisting Septic System <br />_ _E_Xistln~ Tank Size:: <br /> <br />Proposed Bedrooms;; <br /> <br /> Existing Drainfield Length <br /> __T'j~e_ of System <br /> Date Tank Pumped Existlr~.g Bedrooms:: <br /> ~-)~1 have read th{s application in its entirety and codify th~ the stated information <br /> <br /> t The ~ <br /> <br />{ ) ag ee to b~ld acceding to the ~ubmi~ed pman~nd .pacifications: the laws <br /> <br />MO <br /> <br />ELECTRICAL <br /> <br />Valuation <br /> <br />Btdg Fee <br /> <br />Mobile Home Fee:: <br />F~eet 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 /> <br /> //$6' <br /> <br />3¢. ¢& <br /> <br /> <br />