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Marion County Health Department <br />Environmental 'Mealth Division <br /> <br />_~n~.grtl~.0~ ,~or Pr~p~raf~n of Plot Pi~.~_ <br /> <br />Indicate northe~ly direc%iono <br />Show lot liD~s a~d dimensions Of <br />Proposed land ~vision (i~ applic~le).--~'~ ~4~ <br />~mope~ty iden~ica~on (~ence l~nes, l~k~, adjac~% prop~ty addresses). <br />~atian of pro~sed buildings ~d ~y e~s~ng buildings. <br /> <br />~a~on of e~s~ng o= proposed <br />rivers, s~e~s; or l~es witch 100 feet of ~e prop~ty. <br />Pro~sed sewage sys~ loca~on. <br />D~ection of slope ~d app~ate slope. <br /> <br />F ( date ) <br /> <br />EH-S8 7/74 <br /> <br />'(signature of a~plicant) <br /> <br /> <br />