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[FOR OFFIC~ USE ONLY <br />Received B: /~ ~ ~e~ <br />I Zoning ~'~afion f f~,~t~ <br /> <br />MARION COUNTY BUILDINCt INSPECTION <br /> <br /> BUILDING PERMITAPPLI~A6~t?O~ OOS <br /> Al{ION COUNTy <br /> ~UILDIN~ INSp~ <br /> <br />FOR OFFIC~ U~ ONLY <br /> <br />City Setback RcquimmcnU: <br /> <br />1. Job oescrlptton , cb / 1( N <br />I~SIDENTIAL COMMERCIAL ( )New Use of $tmemm: <br />( )Addition ( )Relocation ( )AddMon ( )Sign Ot'~i~J'~fft//6ff}~'~ sf <br />( )Dcmolid~ ( )Alte~tion ( )Demoliti~m t~' <br />( DfAccgssory ( )Other ( )Cba~geofOccupancy ( )Other <br /> <br /> d q732S' <br />2. Location of Installation $, ~,, /-/t,l ~,~ ~12,1/e. (2/ ~ <br /> <br />~o~ar~,, ~/7 ~l/e~a~ 'D~ ~xA=~o. Cr~'S=,~4,7~ ............................ <br />SuMivis~ ~ Bi~ <br />I <br /> : Pfiva~Wcll ( ) Spring ( ) <br />'LoiWid~ ~, L~ Rql A~a I~.~t ff~ Comer ff~ CommuMtyWeU( ) City (~' <br /> <br />3, Contractor Information <br /> <br /> ) I own, msldc in, or will ~side in ll~ completed <br /> <br /> ) I understand that I most r~gist~r as a constmcdc~ contractor if lhe stmcm~ is sold or offered for sal~ bcfor~ or upon completion. <br /> ) ~ will be my own g<eral contractor, <br /> <br />If I hire subcontractors, I will hire only subcontractors registered with thc Constmcticca C~traetors Boa~. If I change my mind and do hire a genera] contractor, I will contract <br />~th a contractor who is ggist~r~d withe Constn~on Contractors Board, and willimmedlately notif~ Marion County of the name of the ccatracwr, <br /> <br />(~am a reglstemd builder OR thc authoriz~l rep~senta~ve of a registered boildec, <br /> <br />4. Fee Schedule <br /> <br />J Mailing Address: LPho~e: <br /> <br /> B. Miscellaneous Fees <br /> <br /> (1) Driveway w/curb@ $7.50 <br />Valuatloa: $ ~/~.~'~ ¢2) Ddwwayw/o~$~7,~ <br /> ~q' ~ O) Si~ ~ Renew (c~e~ ~ly) ~ $79,~ = __ <br /> ; ~ (4) Addi~al ~ Renews ~ Add~dums <br /> ~ (5) ~vesagaa~ F~ = __ <br /> <br />Ir ehveerer ~bey~ ~;e~iof yf th~ aa ~ to~i~ .a bo v e infon~ati0a ~s c~c~ and tha, I have mad =d und~.t~d ~c ~r~Q~ N~cc ~ Pr~e.y Ow.ers a~., C~stm¢fi0n R~ap~sib~fic~ on ~c <br /> <br /> Site evaluations, septic, ele~fical, plumbMg <d m~nical wo~ require so.ram ~its. Check wi~ Marion County g~ldmg Inspeaion ~fom su~itting this appUcafion, <br /> MC 15-73 Rev 8/94 <br /> <br /> <br />