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MC: I%60 <br />Rev. 11/9t <br /> <br />· Property Owner: <br /> Situs Address: ~ <br /> <br />SITE PLAN FOR PROPOSED DEVELOPMENT lin MARION COUNTY <br /> <br />Lot:.,~__ Block, <br /> <br />S ulxlivlsion:~ No. Acres: <br /> <br />Tax,Account #: <br />Zone: Map: <br /> <br />Sex:; Mg]O~ T ~ Range: ~'~- <br /> <br /> I' <br /> <br /> · Drawn By: <br />I certify that ~he abOve information is accurate to the best of my knowledge. <br /> <br />Applicant's Signature: <br /> <br />PLANNING: <br /> <br />PUBLIC WORKS: <br />BUILDING INSPECTION: <br /> <br />FOR OFFICE USE ONLY <br /> <br />Dale: , <br /> <br />Da~: <br /> <br />Date:. <br /> <br /> / <br />~ / ~OG <br /> <br /> "I~ANtON COUNTY <br /> BUILDIN~ INSPECTION <br /> <br /> <br />