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MARION COUNTY BUILDING INSPECTION <br />r Fo.. OF.C O LYI /t/& 220.i hs i <br />Rece~vedbv: /)~ ~ [ SMem~OR~ ~ ~ ~ ~[~ckReq~r~e~t~ / [ <br />I zoningVal~ation~ ] 8:~am-4:3~o~-5147 [~j /~ IReac /~ / <br /> F~ss-*~4so[~ O 6 19911 - I .... ' ~ I <br /> MANUFACT~ED STRUC~RE PLACEMENT <br /> COYOTE ALL SEC~ONS. ~ T}mOUOff 4 PER~T APPLICATI~[0N ~0UNTY <br /> 1, Job D~cdpOon BUILDING IN~PEGTION <br /> <br />2. Location of I~ ,stallation ~-TJ'df// ~/~. ~; ?.~-~.5- <br /> <br />3. Contractor I. nformation <br />~rope~ty Owne[_J~/.~ff~. ~ ~ "lMaillngAgdmss IPhone No'. <br /> ( ) I own. reside in, or w~ l~side in the completed structure. <br /> ( ) ! u~deaStand that I must register ax a ¢onslmPt/on contractor if the structme is sold or offered for sale before or upon completion, <br /> ( ) I w~ll be my own general ecmtraPtor. <br /> <br /> immedlately no~y Marion County of the name of the conl~aPtor, <br /> <br /> ( ~ ,~ a ~;gi~ builder OR ~e auao~'~d m~senm~ve of a ~gise~d b~Ide, <br /> <br />, 4, Fee Schedule <br /> <br />A, (1) Manufactured Home <br />or Modular Unit PlaPement,/COmlectic~ @ $I82,00 ~ <br /> (2) State ~ee ~ 20,~ = ~, ~ O <br /> ~ 9.~o=~ <br /> <br />(~)z~ <br />~. (I) Mf~.'d Stmctu~ Storage Fee <br /> ~ $25.~., <br />(2) ~g.'d Stmcmm Stooge R~ew~ ~ 25.~ = <br />(3) 7~nj~g Sumha~e (15.~ ~ a~Iicable) ~ I5.~ ~ <br /> <br />TOTAL: <br /> <br />C, Addidonallmpeet/0n @ $60,(X)=__ <br /> or Relmpect/on <br /> <br />D, havest/gation Fee <br /> <br />@ 40,00 per hour (2 hour minimum) <br /> <br /> @ $40.00 <br /> <br />TOT^~= $ ~ff~'.,?~ <br />R~ca~r: ~ 7/ <br /> <br />1 hereby ccnit~ that the above ilffotmafion is correct and that I have read and understand the InIormation Not/ce to Property Owners about Construct[On Respon sth/litle~ <br /> <br /> <br />