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MARION COUNTY BUILDING iNSPECTION <br /> FOR'.OFFIC~ USE ~)NLY] .... 220 High StreetNl~ ~ ~. I FOR OfFiCE USE ONLY I <br />~'ZoningValidat~~ ] $:~4:~m~=Sss-S~f ~ ~ ~ ~1~4~ d~ I~:/~ / I <br /> <br /> ALL S~C~ONS, t ~O~G~ 4 PER~T AP~ICATION ~ · ,:~g~ ~~ <br /> <br />2. Locafionoflnsmlhfion <br /> <br />3, Contractor Information <br /> <br />{ ) I ~ ~ my own gme~ ~ntmctor. <br /> <br />ff I lfim ~ubcontractora. I will him only ,ub¢ontractors r~gistexed with the Construction Cmtracton Board. <br /> <br />If I change my mind slid do him a general contractor. I will'contmct with a eoltractor who is registered with the Construction Contractor's Bo~ rd. and will <br />hmnediately notify Marion County of the name of the ¢ontracthr. <br /> <br />or Modular Unit Placem~lt/C~m¢ction @ $182.00 <br />(2) State Fee @ 20.~= <br /> ~ 9ac= <br />(3) Stat~ Sur~a~ ~ 15,~ <br />(4) <br /> <br />(I) Mfg,'d Structure S~rage Fee <br />(2) ~g,'d Stmemm $~ge Renewal ~ 25.~ <br />~) ~g Sureha~e (15,~ if app~eabl=) ~ 15.~ =__ <br /> <br />C. Additional Impection @ $60.00 ~.__ <br /> or RrAnspectinn <br /> <br />D. Inves~ation Fee · <br /> <br />E. Other inspections not llst~d <br /> @ 40.00 per hollr (2 hour min{mur~) <br /> <br /> $40.00 = , <br /> <br />~:c~rr: ~-/~ <br /> <br />I hereby eerdfy that the above infon~ation is correct and that I have mad and under, rand the Information Notice to Property Owners about Construction Responsibilities <br /> <br />NameofApplicant(peasep ~{-Ca3 Phone' 76 ?' 77'[ / <br />S gnaumofApp can /~-~ Dat~: ~ ~7/re z <br />This fee to.vets the manufactured~ctare placement, plumbing connection, electrical connection md mechanical ¢omlection. Site ~valuation scptic permit electrical <br />service or plumbing water/sewer lifies a~ separate required pemlits. <br /> MC 15-64 Rev 11-91 <br /> <br /> <br />