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MARION COUNTy BU~cI~G INSPECTION <br />"bOR ol .icf, ::0 zeig t. ' [ OR OVV C OS Vl <br />Received by.~ I ~ $~m,~~//]g~ ~ I <br /> <br /> MA~AC~O] STRU~ P~lJ] <br /> CO~L~T~ ALL ~'~ON3 <br /> <br /> ( ) <br />Co~c~( ) New( ) R~t( ) ( ) D~aehed <br /> <br />Location of Installation ~-~t-~4 ~f~t~. ¢~'~3',~ <br /> <br />3, Contractor In/~ormation <br /> <br /> )Iown, r~sidein, otwRlresldelnth~omplemdstm~mt~. <br /> ) I understand that I must register as a eonstru~im oontractor ff lh~ stmctm~ is sold or ~emd for sale b~om or u~ ¢~plefim. <br /> ) I will l~ Itly own g~ncral contractor. <br /> <br /> him subeontmemm, I will hire only subcontracton mgistexed with thc C~nstmction Contractora Bea~l. <br /> <br />Lroalediately notify Marion Coonty of the narae of the o~ntra~or, <br /> <br /> ~'~a a registevad builder OR thc authotlz~ ~la~sentatlve of a ~giste ed builder, <br /> <br />A, (1) M~nuhctumd Hom~ <br /> <br /> ~ Modul~ Unit Phe, em~t/Connec, fion <br /> (2) State Fee <br /> <br />B, (1) Mfg.'d Sttocmve Storage Fee <br /> (2) Mfg. d Stto¢ are Storage Renewal <br /> <br /> 3 ' <br /> ( ) Zen ng Surcha~e (15.00 ffapplieable) <br /> <br />C. AddltlonalIn~pe~tlon @ $60.00: <br /> <br />D. Invcsrigafion Fee <br /> <br />E. Other inspections not listed <br /> @ 40.00 ~r hour (2 hour minimum) <br /> <br />I hereby certify that the above information is correct and that I have i~ld and m d~rstand the I~ormatlon Notice to Property Owtaem about Const ct/on Respoosibili~es <br />on the revcme side of this form. ' <br />N me °' APPJJCa'It (Ple~~ 5 ~%~ <br /> <br /> .... P P g ' , ' etlon and mechanical conne¢ ion Site eva ua ion septic pem~it, electrical <br /> MC 15-64 Rev 11-91 <br /> <br /> <br />