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I FOR C.ITY VALIDATIONI <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salett <br /> <br />BUnDlE <br /> <br />1. JOB DESCRIPTION <br /> <br />RESIDENTIAL COMMERCIAL o11~[{~ ~ <br />( ~Addition ()Relocation ()Addition ( )New ~ ~, ~ ~ t~..-~' <br />( )Alteration ( )Other ( )Alteration ( )Sign <br />( )Accessory ( )ChangeofOccupancy ( )Other <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION m PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />() <br /> <br />[ am an AUTHORIZED REPRESENTATIVE of the pmper~y owner or coowactor. <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />TOTAL <br /> <br />~$ <br /> <br />.s <br /> <br />I hereby certify that the above information is <br />Permits are non-transferrable and expire if work is not s~rted within 180 dlys of issuance or if work is susp~nd~l for 180 <br /> <br />Signater¢ of Applicant: ~ Date: <br />MC 15-73 R~v 1/95 <br /> <br /> <br />