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FOR'C.I~Y VALIDATIO~J~rl~I~'T~Y BUILDING INSPEC~ON ~ FOR CITY USE ONLY <br /> 1 ~ 1 ~ f ~ ] ~ ~ [ ~ ~U~ DEVELOPME~ C~R ~ <br /> ~eived By: ~ I~Jl~ ~ ~ )~51~h~3;~ - Room 132 /CitySet~R~u~menm: <br /> I~ng V~i4aOon: ~& ~ I[1~ ~ 8:~pm P~ne ~8 5147 <br /> <br />I ' -- ' I ' ~ ~lX 5~-~ <br /> <br /> MARION ACTU D DWELL G <br /> co.~m ~L S~ONS, ~ T.~OR~I~~ INSPEO~MIT APPLICATION <br /> <br />Replacement ( ) Attached ~ <br />( ) Additional Unit Add-on ( ) Detached <br />Name: ~..{O . g"Ig Manufacturer ~- Sections '2. qO '~_~ <br />TypeofSithng: TypeofRoofing: Square Ecotage: ] I ~ No. of Bedrooms: <br /> ( ) Steel <br />( )Vinyl ( )Metal <br /> <br />2. LOCATION OF INSTALLATi°N ' <br />U~u~B~n~? (~Yes ( )No [Wa~rS~ly: ( )~va~Well ( )Co~tyWell ~ty <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE W'HO IS DOING THE WORK <br /> ( ) I am the PROPERTY OWNER and own, reside in, or will reside in the completed almcthr~ and will be my own general contractor. I understand that I <br /> <br />Mailing Address: <br /> <br />4. FEE SCHEDULE <br /> <br />Phone: <br /> <br />B. Additional Inspection/ <br /> (beyond third inspection) <br /> Reinsl~cfion F~ <br /> <br />I hereby certify that the above information is correct. Permits are non-transferrable and expire if work is not starred within 180 days of issuance <br />or if work is suspended for 180 days. <br />NAMEOFAPPLICANT(pIeaseptlnt): .e~. t~..~l~ ~. ~ Oga~S PHONE: ~'~3 ~'~-6"~J~ <br /> <br />MC 1544 ~ 3]95 <br /> <br /> <br />