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MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Streetl~i~, '~, ~. ,-~., ,_. FOR OFFICE USE ONLY[ <br /> <br /> a:uuam-4:30t!altmone~tl147 ~ Ul~_ J'l Il.. ~ , <br /> <br />MANUFACTUREDSTRUCTURE PLACE~ <br />PER~TAPPLICATION . <br /> <br />COMPLETE ALL SECIION$, I THROUGH <br /> <br />1. Job Description <br /> <br />Job Address /(~ ~'S E ~ ~ T= Acct, No, Cross Street <br /> ' ~va~WeB ( ) Spring ( ) <br /> <br />3, Contractor Information <br /> <br /> ) I ova, resMc in, ~ wffi ~side ~ the complemd stratum. <br /> <br /> ) I undemmnd ~at I must m~smr as a c~stmcfi~ c~t~¢~ ff ~e s~ is sold or offered for sale bei~ or u~n c~plefion. <br /> <br /> ) I will be my own gme~ contra~on <br /> <br />hmnediately nofi~ Marion Comity of the name of the contractor. /-~2 ~_ ~ <br /> <br />( ~ am a rcgismmd budder OR ~c au~odz~d ~scnmfivo of a regi~ b~ld¢~ ~ ~e~ ~///~ .~l ~0. ~F- '" <br /> <br />4. Fee Schedule <br /> <br />A. (1) Manufactured Home <br /> <br /> or Modular Unit Placement/Connection <br /> <br /> (2) State <br /> <br /> (3) State <br /> <br />B. (l) Mfg.'d Structure Storage Fee <br /> (2) Mfg.'d Stmetu~ Storage Renewal <br /> <br /> (3) Zoulng Surcharge (l$.001f applicable) <br /> <br />@ 20.00 =.~. 0~ or Reinspeetion <br /> <br /> TOTAL $. ~/~, t'~ E. Other inspections not li~ted (c~ $40.00 =__ <br /> @ 40,00 pet hour (2 hour minimUm) <br />@ $ 25.00 =__ <br />@ 2.5,00--__ TOTAL= $. ~/~/~ ~ <br />@ moo = <br /> <br />I hereby certify that the above i~brmation is correct and that I have t~ad and understand the Information No~i¢¢ to Property Owners about Core,traction Responllbi/ilie$ <br />Name °f Applieant (~~'-~ ~) "~ ~t I~G~ Phone: 7~6 e 77,;' ~ <br /> <br /> <br />