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MARION COUNTY BUILDING INSPECTION <br />FOR. OFFICE US~---'~-~ ~/. 220 H~gh Street i'~ <br /> <br /> MANUFACT~EDSTRUCTURE PLACEMENT <br /> PER~TAPPLICATION <br /> COYOTE ALL SEC~ONS, 1 THROUGH a <br /> 1. Job De~ripfion <br /> <br />2. Lo~ation of : <br /> <br />3. Contractor Information <br /> <br />( ) I ~de~d ~at I must' ~s~t as a const~ c~r ff ~e s~ is. sold or'~e~d for sale befo~ or u~ o~plefion; <br /> <br />( ) I am n ~g~r~ budder OK ~c a~ofi~ m~se~mfive of a ~gis~ b~lda. <br />B, (1) Mtg,'a Srmcm~ S~g~ F~= ~ 40,00 ~r hour (2 hour ~m) <br /> <br />$40.00 <br /> <br />I hereby certify that th6 above infomlafion i$ eorl~ct and that I have md 'anal uhderatand the Information Notice/o PropeI~y'Own6rs about Construction Responsibilities <br />on the revere si~ of this form, ,. <br /> <br />This fee covers the manufactured structure placeracnt, plumbing connection, electrical connection and mechanical ,ormection, Site evaluation, selpfi¢ permit, electrical <br />aervice or plumbing water/sewer lines are s*parate required permits. MC 15-64 Rev l 1,9 l <br /> <br /> <br />