Laserfiche WebLink
FOR OFFICE US~ ONLY <br />Zoning Vahdation'_ -- -. <br /> <br /> [ <br /> MARION COUNTY BUILDING INSPECTION/.~ ~ <br /> 220 High SUeet NE ~)~ [izoR OFFICE USE ONLY'" <br /> g'~ ~-4-3~m ~e 588-5147 / Front' )"" "' Rear' /0 ~ <br /> <br /> MANUFACTURED STRUCTURE PLACEMENT <br /> PERMIT APPLICATION <br />CO~LETE ALL $~C~ONS, 1TI-~OUGII 4 <br /> <br />1. lob ~efipfion <br /> <br />Residential(X) New~) Replacement.( ) Garage or Carport <br /> ( ) Attached <br />Commexc, ial( ) New( ) Replac. e. mem( ) ( ) Detached <br /> Color of <br /> <br />2. Location of Installation <br /> <br /> 3, Contractor Information <br /> <br /> (X) I o~, ~s~e ~, or w~ reside ~ ~e c~plemd ~tm~um. : <br /> ( ) I unflem~nd ~at I must m~smr as a eonstm~m e~tmemr ~ ~e s~a~ is sold or offered for sale before or u~n empletlon. <br /> <br />: ( ) I w~g ~ my om gmeral contraa~, <br /> <br /> If I him su~nt~cto~, I wffi ~ ~ly sube~t~t~ teglster~ wi~ ~e Constm~[~ C~mmrs Boa~, <br /> If I ch~ge my mind and do ~ a gmeml ~ntmemt, I w~ ~ntmet wi~ a em~acmr who is m~smmd wi~ ~e C~s~efim Con/metes Boa~, and wffi <br /> ~me~ia~ly no~ Marion Comty of tho nme of ~e contractor. <br /> <br />Contraotor Business Name & #: ~'~0 ~-e' b Mailhg Address: <br /> ) I am a r¢gist~red builder OR tho authofi:,~ed repmsentatlve of a registered builder. <br /> [Mall/rig Address: 3~p~ e <br /> <br />42 FeeSehedule <br /> <br />A. (1) Manufactured l-Iorac <br />or Modular Unlt PlaeernentlConnectlon <br />~2) Stat~ <br /> @ 9.m = <br /> (~) State Surcharge @ 15.00 <br /> (4) Zoning Surcharge (15.rD if applJeablO <br /> <br />(1) Mfg,'d Structure Storage Fee <br /> @ $ 25,00 =__ <br />(2) Mfg,*d Structure Storage Renewal @ ~S,O0--__ <br />(3) Zoning Sutchafg~ (15,00 if applioabl¢) @ 15.00 =__ <br /> <br />C. Additional In~pccrion @ $60,00 <br /> <br /> @ 40.00 I~r hour (2 hour minimum) <br /> <br /> TOTAL-- <br /> <br />I Imreby certify that the alYOve ioformation is oartect and that i have read and understand the Information Notice to Property Owner~ about Construction Responslbititle~ <br />on ~ha tevets5 side of this form, /) -, <br /> <br />This fee covers the manufactured stmetu~plaeement' plumbing connection, electrical connection and mechanical connection, Site evaloation, septic permit, electrical <br />~ervice or plumbing wamr/sewer lines are Sel~arate requited permits, MC 15-64 Rev 11-91 <br /> <br /> <br />