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MARION COUNTY BUILDING INSPECTION <br /> ~2o High Street NE <br /> <br />8 go a m,.4 30 p m Phone 588-5147 <br />Cod~-A-Phoae ,58~-7904 <br /> FAX 5s~.79ag <br /> <br />FOR OFFICE USE ONLY <br /> <br /> DWELLiNG/STRUCTURAL AND/OR SEPTIC PERMIT APPLICATION <br /> <br />1, Job Description ........... <br />RE~,IDEN,n^L U ~ L~M ~.RC[AI, <br /> <br /> Nc~ SrO ~1o garage I ] Rel~am I Addmon [ ] ~a <br /> ~ I Additm, [ I ~0 ] ~lterat[~ [ I (~r <br /> t ~ ~,~,,~ t ~ m,~ MARION COUNTY 1 ~,,,~>~,,,,~ <br /> <br />2. Localion of Installation <br /> <br />Contractor Information <br /> <br />4. Septic Information (Check where applicable) <br /> <br />'l'e,t lIoles RcaJ2 [] Will Call Wh~.~ T¢~t tlole:~ Read~ [~ <br /> <br />L Fee Schedules <br /> <br />(i,~eludo~ I~I,, M~, PI) <br /> <br />C <br /> <br />D <br /> <br />(1) Permit Fcc <br />(2) 5% State Surcharge ( 05 x B 1 ) <br />(3) ?~>nieg Surcharge ( 05 x <br />(4) Plane Check [65 x BI) <br /> <br />Septic Pees (Inehldcs DEQ Surcharge) <br />(l) Sitc Evaluation <br />(2) ~ev~ $cpt[e Jnstallauon Permit <br /> <br />(5) Maj~ R~tr <br /> Minor Ru~i~ <br /> <br />Subtotal:: $ <br /> <br />(l) Driver, a> w/curb @ 5750 <br />(2) D~w'way 'Mo ~rb ~ $17 ~ <br /> <br />(6) ~er in~di~)~ ~t lined a~ e .... x $40 = ~'",, ''~ <br /> <br /> <br />