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Marion County Department of Public Works <br /> REQUEST FOR EXEMPTION <br />FROM DPdVEWAY ACCESS PERMIT REQUIREMENT <br /> <br />Owner Name: <br />Permit Address: ~ <br /> <br />Subdivision N~e: <br />Nearest Cross Street: <br />Applicant Name: <br />Mailing Address: <br /> <br />Phone: (Home) ~7¢-/;~q'). (Work)__~ <br /> <br />Reference: <br />Bldg. Insp. Site # <br /> <br /> JUN 1.5_1999 <br /> MA~r, lgN~COUNTY <br /> BUILDING INSPECTION <br /> <br />Applicant hereby applies to Marion County to be exempt from the Driveway Access Permit Requirement in <br />consideration of the site address above. <br /> <br />ATTACH A SKETCH OF THlg SITE AND ACCESS in relation [o other physical features in <br />r. he area. (If a common driveway is to be used with other residents to access the County road. indicate all the <br />residents using it. Also, indicate the owner of the property on which the easement exisks.) <br /> <br />BRIEFkY PROVIDE FACTS for consideration in determination of exemption: <br /> <br />v <br /> <br /> Applicant declares he is the owner or owner's agent of the real property whose access ts under consideration. <br /> <br />NOTE: In approximately two weeks, Marion County will notify the applicant indicating whether or not the <br />exemptioa has been approved. If the exemption is not approved, a permit will be required. <br /> <br />A <br /> <br />Approved __ <br /> <br />MARION COUNTY DEPARTMENT OF PUBLIC WORKS <br />Not Approved__ Reason: <br /> <br /> By: Title: Date: <br /> FORM\DWEXEMPT.FRM rev, 1/98 <br />V <br /> <br /> <br />