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MARION COUNTY BUILDING INSPECTION <br />F~R. OFFICE USE ONLYI ? 220 High StrectNE <br /> coae-n.~h~, s~7~ <br /> <br /> MANUFACTUREDSTRU~E ~L~C~MENT <br /> CO~LETE ALL SEC~ON$. 1 THROUOH <br /> <br />FOR OFFICE USE,,,ONLY'I <br /> <br />2. Location of Installation <br /> <br />3, Contractor Information <br /> <br />( ) I own, reside in, or will red& in th~ c, ompl~md <br /> <br /> imrocdiate2y notify Marion County of the name of the contractor, ' <br />. .. ' ...e~ ~ ~,,~,k~ er~ i.. ....... ~,~ ~0- ~ .... <br /> ( ~I ~ a ~gism~ b~der OR ~e au~o~ m~sen~ of a m~sm~ <br /> <br />4, Fee Sch¢c~ul¢ <br />A, (I) Manu~actu~d Home <br /> <br /> or Modular Unit <br /> <br /> ~) State F~ <br /> <br /> (~) State Surcha~ <br /> <br />B. (1) ~g. ~ Stmemm S~orage <br /> <br /> ( ) ~g. d Smctum Swmg¢ R~cw~ <br /> <br />C, Addilonal Inspection @ $60,00 := ~ <br /> <br />D, Invcifigaron Fee <br /> <br />E. O~erln~pe~ions not listcti <br /> @ 40,00 per hot~t (2 hoot min~aum) <br /> <br /> <br />