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'~ype of Building <br />*~J~n,a of Building <br /> <br /> DEPT. OF BUILDING INSPECTION <br /> Marion COUnty <br /> <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br /> <br />APPLICATION FOR BUILDING PERMIT <br /> <br /> Erect <br />Applkotlon is mode to Alter <br /> Repc6 r <br /> <br /> Rt. 3 Box 430 <br />Address <br /> <br />Relocate Building <br />Demolish a Strucl'ure <br /> <br />AUmSVi 11 e <br /> <br />Permit No, ~ <br /> <br />Valuation $ <br />P~rmit F. $ /~'~ <br />Surcharge <br /> <br /> Septic Tank <br /> .... <br />This perm I covers <br /> <br />Lot Block <br /> <br /> 7 <br /> Lot S~ze <br /> <br /> MH <br /> <br />Addition <br /> <br />Size of Bidg, <br /> <br />14 x 64 mobile home - 2 )~edrooms <br /> <br />Number o~ Static4 <br />Occupancy or use <br />Sewage Disposal <br /> <br />septic-installed 1973 <br /> <br />Height in feet ...................... <br /> <br />Water Supply <br /> <br />existing well <br /> <br />Velue ¢:,f entire work when completed, IneJudlng lobar and mot~,~gJS: $ <br /> <br />Builder & No. <br /> <br /> 366 - West Locust st. SLay'ton 769-29?9 <br />Address Phone <br /> <br />Address ~ C~,~j~.~0~r~j~ Phone <br />Address . Phone <br /> <br />Lo loc¢~te ~ mob£1e home <br /> <br />DE$CRIPTIO~I OF WORK <br /> <br /> Conditional Use , Partitioning Variance Case NO, Zayre Change No, __ <br /> <br /> ONLY WORK DESCRIBED ABOVE INCLUDED IN PEP, MIT <br /> <br /> J agree to build according to above description, plans oc~d specifications ond~ulJdlng Code of M~i~n Co~dy. <br /> <br /> ~ .... ~ ~ '., ',' ""E~ <br /> APPLI~TION RECEIVED $E~C TANK /P~N ~INER J PE~IT ISSUED <br /> Apwoved, No~ Approved App~Not Approved ~ <br />~ y ...... uy ,,, oy~---~ j ~y ........ <br /> :.~ 4/30/74 ~ / ~ ~ ~ J ~ . <br /> Dale I <br /> <br /> <br />