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AppL <br /> <br />By: __ ,, <br /> <br />Date: <br /> <br /> ., ~. MARION CO~JNTY <br /> ,~--,~ OEPT. OF BUILDING INgPECTION <br /> <br /> ~0 H;gh ~t.. N.E. ~d Flor <br /> ~le~ Or, on 07301 <br /> R.~ WITH~OW. BL~. A~INI~RATOR <br /> ~5147 - ~5148 <br />5:~ KM.- .... CODE-A-Ph~ ~3, <br /> <br />Permit No. <br />By= . <br /> <br />Type of permit: <br /> <br />B Rge._ ~ <br /> <br />Phone <br /> <br />97325 <br /> <br />Tree ~ <br /> <br />Lot No: -- ,, P, Ik, No: '~' , ~ub dy. <br /> <br />,C~rner? _~'~_,= , <br /> <br />Wa~ef Supply; <br />Sewage <br /> <br />Valuation: <br /> <br />Basement: ; ~--J~. Fee: <br /> <br />Heatin~ <br />System: ;eptic Permit Fee: <br /> <br /> ... .............. <br /> <br />VALIDATIONS: <br />ZONING SEPTIC q PLANS <br /> <br /> Date, <br /> <br />I agr~ to build acc~dtn; to ~he ~ecific~t~ns. <br />C~n~. ~mit ex~s if ~k ~of ~ w~ifl <br />701.~ to 701.126 <br />( ) lama~build~m( ) <br />( ) ~e ~rk will ~ ~ by a ~ build~ ....... <br />( J I am ~formi~ wo~ on a p~r~ / own or <br /> <br /> PLEBE NOTE:-- "Drily a~ <br /> <br /> <br />