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"~ . ::'~ ' ~IARION COONTY BUILDING INSPECTION <br />City ~ <br /> <br /> BUILDI~ MOBILE HOME ~ SE~IC ~ PERMff APPLI~ON <br /> <br />Subdivision: <br /> <br />Mobile Home Perk: <br /> <br />..~te No.: <br /> <br />C~asStreet: <br /> <br />Fleet S/C Zone; <br /> <br />Block; <br /> <br />Total # Spaces; <br /> <br />comzacter euslne~ Name and No,?'"' ;~ ?-<'¥.~ <br />ArchiteCt/Engineer: <br /> <br />; peof Permit: ~ New: rq A~clition: [] Demo; [] <br />~.p'T't ~ Aiter: ~ Relocafian; J~ Oc~. Chg,: [] <br /> <br />Mobile Home <br />Width: <br /> <br /> Review~ m <br />oe~dpancy; <br /> <br />Existln~,.Tank Size: <br />Existing Drainfield Length: <br /> <br />Type of System: <br />OS~e Tank Pumpec~; <br /> <br />Existing I~e~tooms; <br /> <br />OTHER PERMITS REQUIRED ~IY THiS DEl'T_: PLUMBING, MJECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev, 12/87 <br /> <br />Use of Bui.~ing; <br /> <br />Sq, Fl, Garage: ] Other: <br />o~. ~i Load: <br /> <br /> $ <br /> <br /> 8~g, Fee: <br /> ~lle Home <br /> R~t Surehs~e: <br /> <br /> ~ ~ur~ge: <br /> PI~s C~k Fee; <br /> Site Evalu~10n F~; <br /> <br /> DEQ <br /> <br /> In~stigeti~ <br /> City Fee; <br /> T~AL FEE,. <br /> RECEI~ NO,; <br /> <br /> <br />