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MARION COUNTY BUILDING INSPE~ION <br />[ FOR OFFICE USE ONLY 220 High Streei~, .',. <br /> <br /> CO~LETE ALL $~C~ONS, 1 TI~OUGH 4 PER~TAPPLICATI~ ........ <br /> <br />2, Location of Installa,d,on ...... <br /> <br /> Site No. <br />Mo~omePa~ S ~ I ~ ~ N( ) <br /> <br />3. Con~ctor infomation ,~ g~ ~ ~1~ <br /> <br />( ) I un~$~ng ~at I mint ~¢s~r ~s a c~st~ c~amr ff Ce a~a~ is sold ~ off~ tot sale befo~ or <br /> <br />If I him subcontractors. I will hire only subcontractors registered with the Construction Cc~ltfaetor~ Board. <br /> <br />If I ehallge my miad ~md do tfir~ a general contl~¢tor. I ~ contract with a o~Ita~tOr wl}o is/~g~$t~r~ vAth thg Constra¢fion Contraator's Bostd. and will <br />immediately notify Madoli OounW of the nam* of the contractor. <br />Contmator Bus'eSS Name & #: , J Mailing Addn~: I Phone: <br />( ) I am n registered builder OR the authorized representative of a r*gismexl builder <br /> <br />4, Fe* Schedule <br /> <br />A. (1) Manu£actttmd Hom~ <br /> <br /> or Modular Unit PlacemealldComaectlon <br /> <br /> (2) State <br /> <br /> C3) State Surcharge __ <br /> <br />B. (1) l~ffg,*d Structure Storage Fee <br /> (2) /Vifg.'d Structure Storage Renewal <br /> <br /> (3) Zoning Surchalge (15,00 if appli~ble) <br /> <br />D. hvesti~at/oa Fee <br /> <br /> @ 40.00 p~r hour (2 hour minimuta) <br /> <br />(~ $60,00=~ <br /> <br /> @ $40.00 =__ <br /> <br />TOTAL= $ <br />RECEIPT'. <br /> <br /> <br />