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Owner: Phone .... Ma ngAddress ,3,?,~", <br /> · ~ , ~ ........ : ,~ ~ · .... <br /> <br />"~'~sidentiah ~ New: ~ Addition: ~ O~upancy UseofBuIIdlng: ' ': · ' ' <br />Commemiah ~.;~.,, , Art~ration; ~ Relocation: <br /> <br /> Residential ' <br /> New constru~tion (each fixture) , //./;/~..~_~o--~ ~ ~ ~ $ 9.00 <br /> <br /> Re-located Residence (each figure) ~ ~- . ~ 4,50 <br /> New Construction (each figure) <br /> Alterations (each fixture) 9.00 <br /> <br />Water Lines , · ' ' <br />Fo~ the first 100 feet or fra~lon them~ <br />~lmt ~00 foot o~ ~aetion tho~o~ ........... ' <br />gddlflonal lOOfoot ,. ,. ....... <br />(maximum ~ f~t I~noth) ~ ' <br />'-., <br />On-~it, Tochn~cal ~v[~w (~pl~ ~t Marion Goun¢ only) ...... <br />.... · <br />with the indicated fee ..... <br /> <br />( ~ I I am performing wOrK oll a prope~r~y I own or occupy. <br /> 3ther <br /> <br />MC 1~-4~ <br />~ev. 12/87 <br /> <br /> <br />