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Received 8y ..... MARION COUNTY BUILDING iNSPECTION <br /> <br /> ICKy Setback Reqqirements;: ._ <br /> <br /> MOBILE HOME ~ SE~iC ~ERMIT APPLICATION <br /> <br />~.r ~ ~ 'Proper~y Tax Lot ~o,;: Flee; S/C Zone <br /> <br /> Architect/Engineer ~ <br />L .... ": <br /> /' <br /> <br /> Height Of 8uildi~ / ~ NO. 8tore' ~,, Fl,, ~k ~i~r- ~ <br /> <br /> ...... Z~ i .... <br /> Mobile Ho~ / ~ Mobile <br /> Width ~ Length' , <br /> <br />Tech <br />Review~ [] <br /> <br />Sq~ Fl, 2nd <br /> <br />Occupancy <br /> <br />USe of Building:; RES <br /> COM E' <br /> <br />SCl Fl, Garage:: Other:: <br /> <br />Occupant Load <br /> <br />Proposed Sepb¢ Ine~ilat~nt <br /> <br />T.~,.e. of System: <br /> Te$[ Hoie:~ Ready;:~ <br /> Will cell whee holes re~ly' <br /> <br />6yiccting Septic System:: <br />~xlst!pg Tank Slze~ <br />Existiq,9 Orai~fiekt Ler'~th <br /> <br />Typo ef SXetem;; <br /> <br />Date Tank Pumpgd Bedrooms <br /> <br /> ~ I a~r ee t0 b~tl¢ t~oco~dlng Io the submitted pla~ an¢ specifications, tll~ la-~'~"~of~ of <br /> <br />OTHER p~R~IT8 REQUIRED BY THIS OE~,: PLUMBING, ~EOHANIOAL, ELE~RICAL <br /> <br /> Bldg Fee;: <br /> <br />Mobile Homo Fee <br />Fleet Surcharge, <br />Zoning Surcharge:: <br />State ~urcherge:: <br />Plans Check Fee:; <br />Site Evaluat~ofl Fee <br />~eptlc Permit Fee <br />DEQ Sorcharge, <br />Technical Review Fee- <br /> <br />Retn¢pe~i~n Fee; <br /> <br />Inve~llgation Fee: <br /> <br />C~ty <br />TOTAL FEE::' <br />RECEIPT <br /> <br /> <br />