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FOR OV~[C//~. USE 0NLy <br />Received By: [~-~ ~ ~ <br /> <br />MARION COUNTY BUILDING INSPE~ F_XQI~A~t=OFFICE USE ONLY <br /> <br /> m 01 <br /> 220 H1 h S~t ~ t. , ~ Reqm~enU: <br /> <br /> 8:~ - 4:3 ~ 588-5 <br /> <br /> F~ 588-7948 <br /> BU~D~G pERM~ APPLICATI~[0~ <br /> <br />COMPLETE ALL SECTIONS, 1 TFIROUGH 4 ~1.~ INsp-~v[10N <br />I. Job Description <br /> <br />2. Location of Installation iff. r~Td:Y-~ <br /> <br />..J,o~,Add~s~ 3J/ ~-,~J~t~ ~, ~. Tax Acc[. No. Cr~s Street ~T~ <br />Subdlvfs~ ~ Bl~k <br /> PffvateWel{ ( ) Spring ( ) <br />L~Wid~., ~t*~h ~, Ac,s Idg.~,~ Comer ~d Commu~tyWeU( ) Ci.[~. () <br /> <br />Contractor Information <br /> <br /> ) I own. ro~ide in. or will r*sid~ in <br /> <br /> ) I understand thai I mas* mgis~e,* a~ a eonslmction contm~r ff the ~tm~Jl~ i~ ~old or off~reg for ~ale before or upon eomple~ion. <br /> <br /> ) , will be my own Seaefal ¢on£ra~or. <br /> <br />Lt- I trim sub¢ontractor% I will him only subcontractors reglstere~ with the Constmclion Contra~iorg Board, If I change my n~nd and do },irc a general contractor. I will contract <br />with a contractor who is registered wJlhe Constmctlo~ Ceotmetor's Board, ~md willil~.mediately notify Mahon Coutlly of the name of th~ contractor, <br /> <br />Conlractoj Business name & # Marlin Add <br /> ("'J"I"m ~restsm~abail~yrORtheauth°nz~d r~Pm~e/ntauw°famg]$t~mdbaild"r, ~ F. '~. £ J ~- /,~ #~- Or,~ <br /> <br />4. Fee Schedule <br /> <br />B, MJs~,llanc~s Fees (1) Driveway w/o~rb@ $7.50 <br /> <br /> (2) Driveway w/o cu~ ~ <br /> <br /> ¢) Site ~an Rg~ew Cmme~al ~ly) <br /> <br /> (4) Addi~aI Plan Reviews or <br /> <br /> (5) ~vesQgafim Fee <br /> <br /> (6) ~s~ Fe~ $~5.00 <br /> ~) O~er~cfions ~ol hated above <br /> <br />,' '---' <br />MC 15-73 Rev. 11/9I <br /> <br /> <br />