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FOR OFFICE USE ONL~ <br />Recelved'B¥: <br />zonm~ Vahdagon <br />Dat~: ...... <br /> <br />I{/IARION COUNTY BUII~ING INSPECTION <br /> a,l,~ Olt 97~o~ <br /> <br />1. Loc2tlon of In., s]lation <br /> <br />3. Fees <br /> <br />~_m_ me~clal IDSF. i~ilv Sewage FIowl <br />S~fld~d Sygem ~m ~ I0~ ~. ~: <br />Holding T~k , , ...... ~4~.~ 10.00 <br />_~page Trench 245.00 ,10-00 <br />Plan R~i~w <br />~pairr ~flot ~f,~, I0:~ <br />Au~o~!,o~ Nobce ~o ~eJd Visit) 85.~ :I0-~ <br />AnnyM ~v~lu~on o~.~m~v~ Sy~em ..}.50.~ I0.~ <br />Aunt{ ~vai~agon of~r~ S~m ~.~ 10.00. <br /> <br />(Mark ii' Applicable to Mis Applied{on) <br /> will tall when <br /> <br />NAME/O~f APP~I~CANT (~e,sc <br />SlG~t4'mRE OF a~Li¢~: OATE: <br /> <br />MC 15-$I REV 2/93 <br /> <br /> <br />