Laserfiche WebLink
( ) Atta¢l~ed <br />Cornmeroial( ) New( ) Rephcemmt( ) '"'//04/ ( ) Detached <br />ManufacmreFs , Ycar c4 { Color of ~g~: ~ ~ Wider <br /> <br />Subdivision Lot {~1~' Urb= O~th <br /> PfivamWe~ ( ) Sp~g ( ) <br /> <br />3. Contractor Information <br /> <br />( ) I und*~mnd ~at I mint m~s~t as a ~st~ c~c~ ff ~e stm~ ~ soM or offend for s~e ~fom or u~n c~plefio~. <br />( ) I ~ ~ my o~ gme~ c~t~. <br /> <br />ff I him subcontractors, I will hi~ only subcontractor~ resister~l with the Construction Ccmtractors Boar~. <br />If I ehtmgc my m~d and do him a general e~muactor, I will contract with m cCmlractor who is registe~xt with thc Constmcllon Contractor's Board, and will <br /> <br />(/~) I am a regist¢~¢.d builder OR thc authorized i~Fmsgllt~five of a rcglste, red builder. <br /> <br />4. Fee Schedule <br /> <br />A, (1) M~.nnf'actured Home <br /> <br /> or Modular Unit Plaoemem/Cc~me,xion <br /> (2) State F~ <br /> <br />B. (1) Mfg.'dStmetumStoragel~ee <br /> (2) Mfg.'d Stmctur~ Ston~ge Ren*wal <br /> <br /> (3) Zoning Su~.ha~Se (15,00 il al~ilmble) <br /> <br />~ $ 25.00 =~ <br />@ <br />@ 15.00 =__ <br /> <br />C. Addifionallnspe~tion @ $60,00 =__ <br /> or Relnspeetlon <br /> <br />D, l~vostigation Fee <br /> <br />Other insl~on~ nat listed <br />@ 40,00 Fer hour (2 hOur minimum) <br /> <br />I h~mby ce. niJy that gn¢ above information is commt and that I have ~ad and understand the Information Notice to Property Owners about Construction Responsibl/itie~ <br />on the reverse side of this form. <br /> <br />Thi~ fcc ¢over~ the manufactured structure placement, p]umblng oonnectlo~, 61e-ct fical ¢onnectlon and mechanical ¢onne~ztlon. Site evaluation, septic permll, electrical <br />service or plumbing water/sewer Il/les are separate required permits, MC 15-64 Rev 11-91 <br /> <br /> <br />