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.FOR CITY VALIDATION <br /> <br />Zoning Validation: <br /> <br />Date: <br /> <br />285 Church St. NE - <br /> Salen <br /> <br />24 hr. Inspection Line <br /> FAX 588-7948 <br /> <br />INSPECTION <br /> <br />FOR CITY USE ONLY <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />1. JOB DESCRIPTION <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WltO IS DOING THE WORK <br /> <br />() <br /> <br />() <br /> <br />4. FEE SCHEDULE <br /> <br />A. <br /> <br />Re~s~afion No. <br /> <br />on square footage of project) Valuation: $ <br />~) P~nnit Fee <br />~ 5% Sta~'Su~char~ 605 x Al) <br /> <br />(4) ' e,n . <br /> <br />_-$ <br /> <br />I hereby certify that the above information is conect. <br />Permits are non-transferrable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. <br /> <br />Signature of Applicant: Date: <br />MC 15-73 Rev 1/95 <br /> <br /> <br />