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COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. JOB DESCRIPTION <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Churoh St. NE - Room 132 <br /> <br /> MARION COUNTY <br /> <br />L~ft Side: I Right Sld~: ~ ( <br /> <br />RESIDENTIAL .... COMMERCIAL ~,,~.~,.,ll'll.l IlllOl"l"lj J D~ls~ of Structure: <br />( ) Addition ( ) R~location ( ) Addition ( ) New ~'~ ~ r <br />( ) AIm~tion ( ) Other ( ) AReraflon ( ) Sign <br />( ~ccesso~ ( )Ch~ofOccupan~y ( )O~er /~ ~ ~ <br /> <br />2. LOCATION OF INSTALLATION , ~.ddot~/,t~ttr/P't ~/-~ C/7,~ '~/ <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br /> ( ) [ nm a CONTRAGTOR ragiatezed w[lh Ih~ State of Omson. <br /> <br />4. FEE SCHEDULE <br /> <br />I hereby ccrtit~, that thc above information is correct. <br /> <br /> <br />