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MARION COUNTY <br /> <br /> Please complete all Sections, I th ~r. SmEIVTI~L I'l CO~gRClAL {~ US£: <br /> <br />1. LOCATION OF {]q'~'TAI.I.A']'J[ON ~,, OAS ~ I:LEC'riUC O <br /> BASE trEE A,,.~'ESSED ON ALL APPLiCATiONS <br /> <br /> FROPERFY ~ <br /> <br /> D~O~ <br /> <br />I~ ~ N~-~NS~ ~ ~WO~ iS ~ <br /> ~ ~ I~ DA~ ~ ~U~E OR <br /> w~ ~ S~ ~ 1~0 DAYS. <br /> <br />CONTRACTOR INSTALLATION ONLY <br /> <br />REGIS21tATION NO. <br />C~3U'q'FRAC'TOR.'S $10N,ATI.ER~ ~ ~ ~ <br /> <br />2B. FOR OWNER INSTM.L&TIONS <br />pmt:,e.ny Owue~ (fft~ primo <br /> <br />Owuet'$ Sigoatmue <br /> <br />3. Pl. didfl REVIEW SECTION <br /> <br /> Marion County doe$ not requi~e a plan review. <br /> We will provide plan t~view service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />D..P. cimp~c~or, Fee <br /> <br />TOTAL AlViOUNT DUE <br /> <br />MC 15-41 7/~7 <br /> FEB-10-1998 08:02 1 50~ 588 7948 97Z P.O~ <br /> <br /> <br />