Laserfiche WebLink
VOR. Om. % F,ONLY] <br />Received by,' / <br />Zoning ~Va,lidation'~ <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 High $~;~ /'~ ~/ ~E' [~{~R OFFICE USE ONLY I <br /> <br /> MANUFACTURED STRUCTURE PLACEMENT <br /> <br />1. Job Description ~ <br /> <br />2. Location of Installation <br /> <br />Subdi~s~ ~O~ ~ ~nfi~lo~ ...... ~ 7-~ ]Bl~k ,,,~ UrbanO~wthBoundaw?. <br /> <br />3. Contractor Information .. <br />?ropez~yOwn~r, ~, tt.,it,~,~.~J¢.-,l~-~~ . . I~[A~%'~~e' - ....... [~.~o, /~1~ <br />~ I o~, ms~ m, ~ w~ m~e m ~ ~m~d s~u~. ~ ' ' ...... <br />~I undg~d ~at I must ~smr as a ~st~ c~c~ ff ~c *~ ~ sold or ~emd for sM¢ befo~ or u~n c~ple~, <br /> <br />If I h~ ~ubcontraetors. I will hl~ only subcontractors r¢gistered with the Conslxuetion Contr<tors Board, <br /> <br />If I change my mind and do him a g~neral ~,ntracmr, I wR1 ~ontract with a c~traCtOr who is mS~st~red with the Co~stractio~ Contractors Board, and will <br />knm~dlat~ly notify Marion ComaB, of th~ name of ~e contractor, <br />Contraotor Business Name & #: ] Mailing Address: { Phone: <br /> <br />( ) I an a regisgmd bulmer OR thc authoti?.~d representative of a tegisgmd bu~ler. <br /> <br />4. Fee Scherlule <br />A. (1) Manufacx~r~d lime <br /> <br /> (2) State F¢~ @ 20,00 <br /> 9,]0 <br /> (3) State 8u~a~c ~ 15,~ <br /> <br /> (2) ~g.'d $~tu~ Sm~ge ~c~wa ~ ~5.~ = <br /> (3) Y~ng $ur~ (1 ~,~ if appllcable) ~ <br /> <br />C. Additional Inspection @ $60,00 =__ <br /> or Rclnsp¢ctlon <br /> <br />D, Inwsfigafion Fee <br /> <br />E. Other inspections not listhd <br /> @ zfO.O0 per hour (2 hour minimum) <br /> <br /> @ Sd0.00 =_ <br /> <br />TOTAL -~ $.__ <br />RBCBIPT; <br /> <br />I hereby certlf¥ that the above information is comet and that I have mad and un~mtand the I~fformation Notice to Property Ova~¢rs abou~ Construction Respon sibilifiea <br />on the reverie side of this fonm, <br />.N, arae nf Applicant (please ~nt ): ~ ~"~W/~e c~t~P/m ] ~- ,,, <br /> <br />service of plumbing wat~r/scwcr lines am s~parat~ r,:qulred permits, <br /> MC I5-64 Ray 11-91 <br /> <br /> <br />