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Please complete all Sections, 1 through 5 <br /> <br /> -- " MARION C. OUNTY <br /> . <br /> I~i L~ ~;,,/ 3~SC~,..[~.~STER DR NE- SUITE C <br /> SAL ON 97305-1398 <br /> <br />Datc: <br /> , u~ uUU~I~:-~? <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />PERM1TS ARE HON-TRAI/S~A~BI.~ ARD EXPIRE IF WORK IS NOT J <br /> STARTED wrrItlN 180 DAYS OF [SSUANC~ OR IF <br /> WORK IS SUSPI~IDED FOR ! 80 DAYS, <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />211. FOR OWNER INSTALLATIONS <br /> <br />Propeay Owner (plea~ prlza) <br /> <br />M~iling Address I l~l°ne <br /> <br />City/St~tc/Z~ <br /> <br />3. PLANRIiVJ~W sraCTION <br /> <br />Marion Coun~ does not requ'tre a plan review. <br />We will provide plan review service if you complete <br />Section 5B and subnlit two (2) sets of plans and <br />specifications with this application. <br /> <br />MC 15.34 1/96 <br /> <br />PERMIT NO: <br />Dato: <br /> <br />0971 <br /> <br />Issued by: <br /> <br />Installation, Alteration o~ Relooati~ <br />200 aml~ or kaa $50.g0 __2 <br />201 ~tal~ Io 400 ~ml~ $60.00 2 <br />401 am~to~OOam[~ $100.00 __2 <br />601 stags to 1000 mnps $I~0.00 __ 2 <br />O~er 1000 mn~ or volts $300.00 -- 2 <br />R~onnect only $40.00 -- 2 <br /> <br /> J~l~lhtion, AII~jIi~, or ReJ~atlo~ <br /> 200 ~ml~ or l~ $35.00 -- 2 <br /> 201 ~ml~ to 400 aml~ $40.00 __2 <br /> 401 aml~ m 600 aml~ $~0.00 2 <br /> Over 600 ~mp~ or 1000 volts <br /> <br /> a) The fee f~ branch ¢ircuils ~ <br /> Each branch clreuit $ 2.00 <br /> <br />$ s.oo 3Z <br />$ Z.O0 <br /> <br />b) Tae fec for branch circui~ ~ <br /> <br />Fa'st broach circuk <br />Each addidoml bra~Iz ck~uit <br /> <br /> E. Miscellaneous (~ or F~' Not Included) <br /> Each pump or in'igatloa civic t;40.00 -- <br /> Each si~n oromliae lighting $40.00 -- 2 <br /> Signal circuit(s) or a limited energy <br /> panel, ~lterafioo or extension $40.00 __ 2 <br /> <br />O~r Ih, allowable ha any of Ihc <br />d~o',.e, ~ Ins0cction $35.00 -- <br />O. Minc~ Installation l.~bels <br />Pack of 10 labels @ $5.00 each $50.00 <br />· (soldon/ytoelectric~lco~ractotO <br />IL Other <br /> (As req~red by l~iIdi~g <br /> Aurora Dwelling Blue.cai Fee __.sq. fl. x $.068=__ <br /> Dwelling Pemait Label # 6f <br /> <br />5. FILES Al. Enter total of fees from Sec. 14 <br /> A2, Add 5% m.~:lu~,~ (.05 x Al) <br /> <br />Subtotal <br /> <br />$ <br /> <br />B. Enter25% of lineAl forPlanRcvlew <br />(Sec. 3), if ~ulrg~ $ <br />C. Inve~tlgalioa Fe, (if requked) $.__ <br />D. Reimpeellon Fee ($25.00) $ <br /> <br /> TOTAL AMOUNI' VI. rig $ <br /> <br /> <br />