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Zoning Validation: <br /> / <br /> <br />BUILDING [] <br /> <br /> r Owner: <br /> <br />Job Addreee; <br /> ¥, ,, <br /> <br />Subdivision: / / <br /> <br />Mobile Home Park: ~/~ <br /> <br />Lot Width: Lot Depth: <br /> <br />MARION COUNTY BUI~r~.,~, I~.PI~'~I(~ f~'/~'Setback Requirements: <br /> <br /> COUNTY <br /> MOBILE HOME ~ <br /> <br /> Address: <br /> <br />Site No.: <br /> <br />Property Tax Lot No.; Zone: <br /> <br />Lot: Block: <br /> <br />Sp. ¢: Total # Spaces: <br /> <br />Acres: fx- ' I~rb,~,.Lot · Corner: <br /> <br />Architect/Engineer: /~ Phone; <br /> <br /> ? <br /> <br />Type of Permit: 1 New; [~ Addition: [] Demo: [] Tach. <br />~,~.'yO f' / Alter; ~;~'Relocation: [] Ccc. Chg,; [] <br /> <br />Review: [] <br /> <br />ReigCt of Building: .... J No. Stories: <br /> <br />Mobile Rome Mobile Home <br />Width; Length: <br /> <br />Sq, FI, Main Floor; <br /># Bedrooms: <br /> <br />Sq. Ft. 2nd FI r: <br />Occupancy: <br /> <br />Proposed Septi~ Installation: <br />Previous Site Evaluation <br /> <br /> Test Holes Ready: <br /> <br />Will call when holes readyr <br /> <br />Proposed Bedrooms: <br /> <br /> Existing Septic System: <br /> <br /> E×lstJ,~....l~r~infield Length: ~ _~.¢. <br /> '~/pe.. of System: ¢ ~. ~¢~4'--¢ ¢¢~ -- <br /> Oate Tank Pumped; ~-~ f ExiSting, aedroom~7.~ <br /> <br />( ) I am a registered bender OR ( ) the authorized representative of a registered <br /> <br />{ ) The work will be performed ~ & registere~ buitde~ . . <br />( v./) Other ~ ~c¢~ ~ ~' [~-~.~d~ <br />( ~"' I agree to b~ according to the submi~e¢ plans~nd specificado~f <br /> <br />OTEIER PERMITS REQUIRED BY THIS OEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev, 12/87 <br /> <br />U~e of Building: RES <br /> <br /> cz_ - <br />Sq, Fl, Garage; / Other: <br /> <br /> Valuation: <br /> <br /> Bldg, Fee: $ <br /> Mobile Home Fee; <br /> Fleet Surcharge; <br /> Zoning Surcharge: <br /> State Surcharge: <br /> Plans Check Fee: <br /> Site E~luation Fee: <br /> <br /> Septic Permit Fee: <br /> DEO Surcharge: -~;;; <br /> <br />Technical Review Fee: ........ <br /> <br />Reinspection Fee: <br /> <br />Investigation Fee: <br /> <br />City Fee; <br /> <br />TOTAL FEE: <br /> <br />RECEIPT NO.: <br /> <br /> <br />