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MARION COUNTY BUII/~ING INSPECTION <br />FOR OFFIC/}E~US. E/ON_Ly 220 High~~ <br />Rec?~ed b~:~ I S~em, ~ ( <br /> <br />FOR OFFICE USE ONLY! <br /> <br />r~,ont: /,~ ~ ~ta~ /$ ' <br />~.eft $~de: /..~t Right Side:/,.~- ~ <br /> <br />~. ~o~ ms. riI t.~on <br /> <br />2. Location of Installation <br /> <br /> $o~vi~ L~ ~ Bl~k Urban G~wth Eoundaw? <br />/ <br /> Se~ ~d Toms~p ~ Range ~ ~ Z~e ~ Map Waif Su~ly: <br /> PrivateWeg ( ) Spmg ( ) <br /> Lot Wid~ t ~ De~h <br />........... ~ff ....... ~q / Acres ~eg, ~t ~O Comer ~O Commumty We~ { ) Ogy {~ <br /> <br /> him subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. <br /> <br />ConUaetor Business Name & #- m~,, ~ /.~ Ma~ng Address' <br /> <br />4. Fee Schedule <br /> <br />A. (1) M~mufaetured Home <br /> <br /> or Modular Uni£ Plaeernont/Connectlon <br /> <br /> (2) State Fee <br /> <br /> (,? 9'~.;::g ~"'~*'*W' (~ '~ ~ ff art <br /> <br />B, (1) Mfg,*d Structure Storage Fee <br /> ~) ~g.'d Stmctum Smmg* Renewal <br /> <br /> (g) ~g Sumha~e {15.ffi if ap~icable) <br /> <br />Additional ~spection ~. $60,00 ~ -- <br />or Rdnspeefion <br /> <br />D, investigation Fee <br /> <br />@ 40,00 per hoot (2 hour minimum) <br /> <br />TO'r^[= ~ dq~ ~'0 <br /> <br />I hereby certify that the above information is correct and that I have ~ad and understand the Information Notice to Property COwrie. rs aboot Construction Responsibilities <br /> <br /> <br />