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MARION COUNTY BUILDING INSPECTION <br /> · Senator I~kJg. No. 225 <br /> L~20 High Street NE <br /> <br /> MOBILE HOME ~ Phone: <br /> <br />Subdivision: <br /> <br />Home Park: <br /> <br />t~roperty Tax Lqt NO.: <br /> <br />Street: <br /> <br />Fleet S/O Zone: <br /> <br />Lot: Bkx:k: <br />Sp- #: Tot~ # Sp~-'es; <br /> <br />Section: <br />Lot Wide; Lot Dep~; Acre~; <br /> <br />Map; <br /> <br />Architect/~nglneer; <br /> <br />yl~e of Pe,'j~ltl , New; ~ Addition: [] <br />~~/ A,ter: ~ Re,ocstion: [~ <br /> <br />Demo: [] Tach. <br />Oc~, Chg,: [] Review; <br /> <br />Height of Bulldlr~g; <br /> <br />Mobile Home <br />Width: <br /> <br />No. Stories; <br /> <br />Mobile Hoime <br />Length: <br /> <br />Scl, Ft. Main Floor; ~q. Ft_ 2nd Floor: <br /> <br />Proposed Septic Instaflafion: <br /> Previous S[~e Evaluation <br /> Type of System; <br /> <br />_ Te..,,_,_st_,H_o,.Le~, Ready: <br />will caAl w~n hole? rea~y_.~ Prol3o,~ct Bedrooms: <br />Exlet[ng Sepf~ System: <br />.,, ~xlst!n_e,.,T.~k Size: <br />, Existing IDralnfield <br /> _Type of <br />, Dot,? Tank Pumeed,_ .... E,..__~_~xlst[,._~_Bc, d,rseme:~_- .... <br /> <br />Use of Suilding: <br /> <br />Sq. It, Garage: <br />Occupant Load; <br /> <br /> Valuer joe: <br /> <br /> 8tdg, Fee; <br /> Mobile Home Fee'. <br /> Fleet Surcharget <br /> Zoning Surcharge= <br /> State Surcharge; <br /> Piano Check Fee: <br /> <br />Other: <br /> <br />Wat~er Supply: <br /> <br /> $. <br /> <br />Septic Permit Fee; <br /> <br />T~h~ica[ Review <br /> <br />Reinsp~tion Fee: <br /> <br />TOTAL <br /> <br /> <br />