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I.~ .~)CAT[ON OF II~STALLA'rlON ~'~O~E~ --~ <br /> <br />Cn~s <br /> <br /> 2~ CO~OR ~A~0N <br /> <br /> u <br /> <br /> ~ ~: ~lgo~e print) <br />I Mailing ~: <br /> <br />Owao*'$ Signora re: <br /> <br />MC 15-34 R¢¥ 9/98 <br /> <br /> MARION COUNT~ BIaI~ING i~SP£CTION <br /> 3150 Lm~l$O Laa~'r Dr. NE -$u~ C <br /> <br />8.~0 am-4'.30 pm 24 hr. Im~a:~a Liae 373-4427 FAX 588-794~ <br /> <br />~ ~2ti I~DUL,E (cmplete and enter 1oral in Al} <br /> <br /> Nundx2- of h._~- ~ ,~ce.s pec pcnnh allo~ <br /> <br />A. Residential Prr Uale, ~ Inclu6exl <br /> Ikm~ <br /> <br />$ ~2.00 ,= $ 2 <br /> <br /> ~. Services or FeVers (Does uo~ bclude b~n~ ~ca~ ~ ~c~a D) <br /> <br /> 2~l~ ~ <br /> 201~ x S80~- S 2 <br /> <br /> ~ Tem~ <br /> ~fio~ ~ or Rdora~on <br /> ~l~ x S ~5.~ = s 2 <br /> ~l~ x S ~5.00 = S <br /> <br /> ~)~r~~ <br /> <br /> Fi~ B~ C~ x S ~.~ = $ <br /> ~B~hC~i[ ~ x $ 3.~ = <br /> ~ M~Haneo~ (~l~ ~ P~d~ Not Included) <br /> <br /> ~Si;~d~Li~ x S55,~ = $ 2 <br /> <br /> , <br /> <br />~ ~d S~ S~h~ (.o5% ~A1) <br /> <br />s ss.oo = $1g)2'' <br /> <br />SUBTOTAL: $ {'".'.'.'.'.'.'.'.'~r.. 3(2 <br /> <br /> <br />