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A <br /> <br /> Marion County Department of Public Works <br /> REQUEST FOR EXEMPTION <br />FROM DRIVEWAY ACCESS PERMIT REQUIREMEI',t~ (t~'~ IID~)~v/ <br /> <br />Permit Address: <br /> <br />Subdivision Name: <br />Nearest Cross Street: <br />Appti~m N~e: <br />Mailing Address: ~ <br /> <br />Phone: (Home~ <br /> <br />Reference: <br /> <br /> SE 15-39 <br /> <br />f,3/,,rz,,..~',~ , .:,..,., . <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 THE SITE AND ACCESS in relation to other physical features in <br />the 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 exists.) <br /> <br />BRIEFLY PROVIDE FACTS for consideration in determination of exemption: <br /> <br />Applicant declares he is the owner or owner's agent of the real property whose access is under consideration. <br />^pplicant:~'7~l~irxO"~~ ~..~C~ Date:~-'PI--~ <br />NOTE: In approximately two weeks, Marion County will notify the applicant indicating whether or not the <br />exemption ha~ 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 /> <br /> Not Approved Reason: <br /> <br /> By: Title: Date: <br /> FORM\DWEXEMPT.FRM rev. 1/98 <br />V <br /> <br /> <br />