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MARION COUNTY BUILDING INSPECTION FOR OFFICE USE ONLY <br /> 220 H~ h Su~t ~ ~" <br /> <br />O~& TWO F~ILY D~LL.G PERMff APPLICATI~ ~ <br /> <br />3. Contractor Inform~tio~ <br /> <br />[Marling Address [ Phoue No. <br /> <br />( ) I own, r~side in, or wilI reside in the eomplet*d stmetu~, ': <br /> <br />( ) I understand that I m~qt r~$ister ~ a 0o~t~on con~aet~ if ~e s~e:js sold or offered f~ sale ~e or u~n eomplefl~. <br />( ) I w~ll ~ my OWn general ¢ontra~or. <br /> <br />who i~ reglst0red WiOl file Colagtru6~i¢l Contractor's B~ar~, I will i~m~e~a?lzjt notify Minion C~nty of ~e namo ~ ne ~n~a~r: <br /> ., ./., <br /> (~ ~ am a registered builder OR ~e ~ori~d re~esentafive of a re,gered ~ld~ <br /> <br />Architect name:~ ~, /ffg'/-I I g/~ ~' <br /> <br />4. Fee Schedule <br />A. New ~e-aa&Two Fa~ly ~lling C~e <br /> <br /> ¢) 3% State Surch~g¢ (,05 x Al) <br /> <br /> (3) Plal~ Review <br /> <br /> (4) Y~ning Surch~e ($15 if applic~le) <br /> <br />= ~1~5.00 <br /> <br />(1) Driveway w/curb ~ $7.50 <br />(~) Driveway w/o curb @ $17.00 = .... <br />(~) Add~fiollal Plan ReViews or Addendums = .... <br />(4) Investigation Fee '-' ...... <br />(5) l~eilaspeefion F~e ~ $25.00 = ...... <br />(6) Other Inst~ctions not listed above : <br />~cvavr :_ / 77 / .... ~ $40 .... <br /> <br />,%,,,.,.,.o,.,,,~..,,.,, a/<¢.~e (¢,.,,_~..2.~, ~,/&xA---/t~cvr) ,;,a., / / / 7/qF- .__ <br /> <br /> <br />