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MARION COUNTY BUILDING INSPECTION <br />FOR OFFIC~ USE ONLY[ .^ 220 l-ligh Street,.~ ,.,,~ ~ m ~ ~ ~FFICE USE ONLY1 <br /> . / <br /> MANUFACTURED STRUCTURE PL~M~ <br /> PER~T APPLICATION <br /> <br />Resldenfi~l( ~ New(l~ Rephcemmt( ) Garage or <br />C~mer~l( ) New( ) ~eplacem~t( ) ( ) Detached <br /> <br />M~acm~r'a Year of Color ~ ~ L~g~: W~d~: <br /> <br />2. Location of Installation ~.f~,,~,~ ~ff.~ qf~d~ <br /> <br />Subdivision ~t ] Bl~k Urban Growth go~ldaW? <br /> <br /> ~ Map <br /> ........ <br /> <br />3. Contractor Information <br />Property <br /> <br />~a~C ~lY~ff~ ,1 MailingAddress <br /> <br />Phone No, <br /> <br />) I oven, resJ. de in. or will reside in the complemd stmctui~. <br /> <br />) I understaad tha; I must register as a construction contractor if the stmettm2 is sold or offered for sale before or upon completion. <br /> <br />) I will be my own general e. ontraetor, <br /> <br />!mmedhtely notify Mari ,o~.,,,County of the name of the e. ontraetor <br />(~'amaregi~temdb~lderOR~eau~ofi~d~p~sen~veofamgi~temdb~d,r, ~ ~ ~ ~ /~ ~, dre q 73 ~ ~ <br /> <br />4. F~¢ Sch¢~u1~ <br /> <br /> or Modalar Uta~t Pla ce, men~lCerm ec'tion <br /> <br />$182,00 = _~,_~ <br /> 20.00= <br /> <br />C- Addltionalin~pectlon @ $60,00.=__. <br /> or Re, inspection <br /> <br /> ('3) State Surehaege @ 9' I 0 ~- ~-e'~O <br /> (4) Zoning Surcharge (15.00 <br /> <br />13. (1) Mfg.'d St~tu~ Sm~g~ Fo~ <br /> ~ $ 25.~ ~ <br /> (2) ~g,'d Stmctu~ ~e ~ncwal <br /> <br /> ~) 7~lli~g $urc~e (15,~ if applicable) <br /> <br />D. Investigation Fee <br /> <br />E- Other inspections not Iisl~d <br /> @ 40.00 per hour (2 ho~lr minimum) <br /> <br />@ $40.00 =---- <br /> <br /> <br />