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DEPT. OF BUILDING INSPECTION <br /> Marion County <br /> <br />R.H. WITHROW, BLDG_ ADMINISTRATOR <br />5~-5147, Courthouse <br /> <br />APPLICATION FOR BUILDING PERMIT <br /> <br />Permit Fee $ /(.~" <br /> <br />Surcharge <br /> <br />S~pl:ic Tank.,. <br /> <br /> ,~o Erect Relocote Building <br /> Repoir Demolish Slructure Thi~ permit co, ers Conslruclioh <br /> <br />L~t Block Addition -- <br /> <br />Number Ot ,~l;l~l~S C~., Bo~emerl~ H0,ght in [eet <br /> <br />Address Phor, e <br /> <br />  _ , ,~ . , - ,~ DESC.RIp1'ION OF WORK <br /> <br />~~.~~ ~;) ~ ;~'- ......... <br /> Conditional Use ...... Partitioning ...... Vat~once ~se No. ~ <br /> ONLY WORK DESCribED ABOVE INCLUDED fN PE~IT <br /> <br />I ¢~9ree to bvdd OCt,),d,,~9 t-, obo,,~* .'l~'~,rril'Hion: plans and ~peOfic~lions and the BuildTl~g C~de o¢ Mar~¢~n Count'~ <br /> <br />',,,, 6~¢1¢~__."~~_~ <br />,, ....... :_~ ~ ........~_ ............... <br /> <br />OTHER PER~ITS REQUiReD BY THIS DEPARTMENT; Heutlng Plumbing <br /> <br /> <br />