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MARION COUNTY BUILDING INSPECTION <br />FOR'OFF]ICJ3 USE O3NLY I 220 High Street NE FOR OFFICE USE ONLY <br />Received by: /-; ~ .? ~ Salemi OR 973_0~1 .... at>, Sett, a~,~j;,'~n. ~nts: . <br /> <br />2. Loca~on of Irtsmll:~fion ~ <br /> <br /> 3. Contractor Infon~ation <br /> Owner ,, Mailing Address {Phone No, <br /> ptop~rt~ <br /> ( ) I own, ~side in, or vail mslde/n the completed structure. <br /> <br /> ( ) I will ~ my own gm~mt ¢ont~ct~r. <br /> <br /> If I h~ru subcontractors, l will hir= only subcontractorx registered w~th the Con~t,(ucmion Ccmttractora <br /> <br /> immedL~mly ,oti£y Marion Co~n,y o~ the nam: of the e. Ontractor.-$~ 2~3~ <br /> <br /> ~ I ama mglstered bulkier OR the authorlzt~d i,=p.seiltatlv¢ ora registeled blxildet. <br /> Authorized aggtg Or ~aSCe: ~' M~i~g <br /> <br /> 4, Fee ~chedule. : , , <br /> A, (1) Mamtfe~ur~dHom~ <br /> or Modular Unk PI~rn~gC~mo~t{on @ $~?,B~]O = ~3-~. O~ C, AddkionulImpecti~n @ $60,00 = <br /> C2) Slate Fe~ @ 20.00 = ~q2 ~k~l or Reinsp~¢ti~ <br /> <br /> (4) ~ <br /> ~vcsdgar~on <br /> <br /> TOTAL: $.~j~O <br /> B, (1) Mfg.'d Stmcturo Storage ]Fee ! @ 40.00 I~r hbur (2 hour i~imum) <br /> (2) ~M~g,'d $~rucmm Storag~ Reatcwal @ $ 2;5,00 ~ .. <br /> <br /> ~3) Zoning $umharge (15.00 ff appllcabl~) @ 15.00 ~- ~. <br /> <br />I hereby certify that the tth~ve informa6on it ¢o~rcet arid that I have ~ad md ~ndc~tand the ~f~nn~ion Notice to Property Owners about Con sttu etlon Respon $ bi]ities <br /> <br /> <br />