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FOR OFFICE iJSE~NLY] MARION COUNTY BUILDING ENSPECTION ]FOR OFFICE USE oNLY <br /> . ~ 220 High Street NE <br /> <br /> ............ ' ' .... ' ' ' <br /> ONE & TWO FAMmY D~LL~q~~CATION <br /> <br /> ( ) New Single Fmily Dwelling w/o gmge ( ) G~~ <br /> <br />$~uarOF~t: B~semant: I Mair~loor: ~/7~'~ , ISe.~ondFl~t: } ~arag~: ~V7 <br />2, Location of Installation ff~/gg f~ 0t~,e q 7Zd~.~ <br /> <br />MoNIe ~ome P~k S~ ~ ...... <br /> ' ~ PrivateWa~ ( ) Spring <br />~tWid& ~0 / ~D~ /~0, O~ A~ ~g'~ ~0 C.m~t Commu~tyWell( ) City <br /> <br />3, ContracCmr Information <br /> <br /> ( ) I understand ~at I mint r~st*r &*a eomt~fi~ eon~am~ it ~* ~* is Sold or offered for s~e ~fo~e or u~n eompl*~on.' <br /> <br /> (2) D~veway w/ocurb @ $17,00 <br /> <br /> O), Addifiotlal Plan lhlvi*wa or <br /> <br /> (4) /nve~fig~on Fee <br /> <br /> (6) ~et Inz~cfioas dot liated ~ove <br />~ecm~: ,~ 77/ <br /> <br /> ,, x$40= -- <br />TOTAL $ 7/d'.5''~.5~ <br /> <br /> <br />