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HomeMy WebLinkAboutPermit Building 2007-10-5 CITY OF SPRINGFIELD Building/Combination Permit Status Issued . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2007-01501 ISSUED: 10/0512007 APPLIED: 10/04/2007 EXPIRES: 04/05/2008 VALUE: $ 161,518.00 SITE ADDRESS: 5363 I ST ASSESSOR'S PARCEL NO.: 1702283402700 SPRINGFIE TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single famliy residence-Thurston Place subd lot 19 Owner: CUMMINS INVESTMENTS LLC Address: 31221 OSPREY RD LEBANON OR 97355 Residential Phone Number: 541-401-5272 I CONTRACTOR INFORMATION. Contractor Type General Electrical Mechanical Plumbing Contractor License Expiration Date DAVIS CONSTRUCTION SERVICES LLC 160347 06/14/2008 EASTSIDE ELECTRIC INC 117770 10/04/2009 MARSHALLS INC 25790 12/23/2009 JOHNS PRECISION PLUMBING LLC 158279,_ " ,~1/13/2008 BU (Q)E'{1~ \b ~~g~~uti\ity n\\O}N, rules a 0 ose rules are set 10rth ',1/ RJ~~center. "~hrOugh OAR 9521AA~ze: r~~g~e.1C~\~ C9'pies~,d09 ru'~r 911st Floor: o ~ 'If>DentW obta 'lNa~tVt~8dft)~ph~r~ 2nd Floor: lt1U\g~:cente~~ on Uti\it~WPti1\~~ ~asement: ~\)~: \h8,O 1lo0-332-~). ~~.ftfGarage/Carport tnergy IGifi\\8I 8 Path 1 Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VB 3 I DEVELOPMENT INFORMA nON I Phone 541-350-2060 541-915-9828 541-747-7445 541- 736-8690 1,400 434 REQUIRED PARKING 2 Overlay Dist: Total: # Street Trees Rqd: 2, Handicapped: Paved Drive Rqd: Yes, Compact: % of Lot Coverage: 23.10 / ~ \NO"\(. Ul),.\rl~~ _"'~' ~'''~ ~~;~,. \S ~01 . I PUBLIC IMPRov.rl>'l-J\'~ tNtlER 11\\'0 ~ONEtl fOR ~U \,\u~1.E Rv\S~~N. Fully Improved W\W\t.NCt.~iQ \OO.ype. Curbside 5' Storm Sewer Available: Yes CO ~&O O~cP~pouts/Drains: Drywell- Provide Special Instruction: For this parcel in Thurston Place, it is thAA~ommendation to the Building Di~liIyHhgi(ilitying Engineer: "that no connections shall be made to sanitary or storm H20 systems, until the Notes: Storm water rouNd>dh6.ciemt~cf}t City Council". Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 20.00 5.00 6.50 10.00 0.00 Subdivision Not Accepted Street Improvements: Pa2e 1 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Ac - Residential V Wood Frame Gara!!:e A.C. - Residen Dwellin!!:s Gara!!:e Fee Description -Mech Iss 2+ Appliances- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge 2 Baths One or Two Family Addressing Assignment Appliance Vent Building Permit Curbcut Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Furnace - up to 100,000 btu Gas Outlets 1-4 Heat Pump Plan Review Major - Planning Plan Review Residential PW Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea AddtI 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Sidewalk Permit Storm Drainage Impervious Area Vent Fan WiIlamalane Single Family I Valuation Description I $ Per Sq Ft or multiplier $4.00 $103.00 $27.00 Square Footage or Bid Amount 1,400.00 1,400.00 434.00 Total Value of Project ~ Amount Paid $40.00 $145.35 $84.84 $108.94 $280.00 $35.00 $7.00 $844.80 $85.00 $7.00 $10.00 $91. 70 $14.00 $5.00 $14.00 $205.00 $549.12 $-40.00 $117.00 $42.00 $489.70 $644.00 $10.00 $990.39 $95.35 $123.26 $73.32 $862.25 $195.48 $85.00 $644.46 $21.00 $2,303.00 Date Paid 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 10/5/07 Pa!!:e 2 of 4 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01501 ISSUED: 10/05/2007 APPLIED: 10/04/2007 EXPIRES: 04/05/2008 VALUE: $ 161,518.00 Value Date Calculated $5,600.00 $144,200.00 $11,718.00 $161,518.00 10/0412007 10/04/2007 10/04/2007 Receipt Number 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 2200700000000001553 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01501 ISSUED: 10/05/2007 APPLIED: 10/04/2007 EXPIRES: 04/05/2008 VALUE: $ 161,518.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Amount Paid $9,182.96 Plan Reviews I Plannin2 Review 10/04/2007 10/04/2007 APP TAJ Street trees may be reduced to 1 if there is not room on the east side. Public Works Review 10/04/2007 10/04/2007 APP TSS Storm water routed to engineered drywell. Structural Review 10/04/2007 10/04/2007 APP DLM Approved as noted on the plans. To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. l....Reouh..eCUnsoections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover.. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. \ Underground Plumbing: Prior to filling the trench and including required testing. \ Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Pa2e 3 of 4 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2007-01501 ISSUED: 10/05/2007 APPLIED: 10/04/2007 EXPIRES: 04/05/2008 VALUE: $ 161,518.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Hold Downs Installed: Special Inspecti,on performed prior to placement of concrete. Provide report to City Building Inspector. Drywell: Engineered Drywell is Required. Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Final Gas: When all gas work is complete. Undertloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. I (0/r:;/111-: . . ~ftl\c Owner or Contracttlrs Signature Date Pa2e 4 of 4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSH~ET JOURNAL OR JOB NUMBER: COM2007-01501 I NAME OR COMPANY: Cummins Investments I LOCATION: 5363 I Street I TAX LOT NUMBER: 17-02-28-34-02700 I DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE .1 NEW DWELLING UNITS 1 BUILDING SIZE (SF: 0 LOT SIZE (Sr): o ifJ ~ .~ o u ~ ~ E-< ifJ ....... o ~ I . DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. xl I COST PER S.F. CHARGE I 640.00 I I $0.346 :::: I $221.45 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS. I IMPERVIOUS S.F. xl I COST PER S.F. x I DISCOUNT RATE I '2445.00 I $0.346 . I 50% = I , I. STORM DRAINAGE DISCOUNT I $423.01 I ;' I ITEM 1 TOTAL - STORM DRAINAGE SDC I 2. SANITARY SEWER - CITY $644.46 $644.46 11070 A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 24 I B. IMPROVEMENT COST: I NUMBER OF DFU's I 24 COST PER DFU $26.83 ) $644.00 1091 x COST PER DFU $20.40 $489.70 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC I = I $1,133.70 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRlPRATE x I NUMBER OF UNITS I x I COST PERTRIP ,. x I NEW TRIP FACTOR I 9.57 I I I 20.43 I I 1.00 I $195.48 ,1093 B. IMPROVEMENT COST: \ I ADT TRIP RATE I x I NUMBER OF UNITS I x COST PER TRIP x NEW TRIP F ACT0R I 9.57 I 1 I' $90.10 1.00 I $862.25 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = I $1,057.73 I 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's x ICOST PER FEU 1 I $95.35 :::: $95.35 1054 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 1 I $990.39 :::: $990.39 I 1055 I MWMC CREDIT IF APPLICALLE (SEE REVERSE) $0.00 I 1054 I . 111056 MWMC ADMINISTRATIVE FEE $10.00 I ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I $1,095.74 I I SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) =1 $3,931.63 I 5. ADMINISTRATIVE FEE: I SUBTOTAL x ADM. FEE RATE CHARGE I I $3,931.63 I 5% $196.58 I TOTAL SANITARY ADMINISTRATION FEE: 123.26 11079 I i 1078 TOTAL TRANSPORTATION ADMINISTRATION FEE: $73.32 - Todd Singleton /0/1//6:]- TOTAL SDC CHARGES =, $4,128.21 PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 1 0 3 = 3 I DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 !INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 1 0 2 = 2 ICLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3 SHOWER, SINGLE STALL 1 0 2 = 2 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 I SINK: COMMERCIAL BAR 0 0 2 = 0 I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LA V ATORY/RESIDENTIAL BAR 2 0 1 = 2 IURINAL, STALL/WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 24 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE I YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 BEFORE 1979 $5.29 (Enter 1 for Yes, 2 for No) 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 2 1980 $5.19 (Enter 1 for Yes, 2 for No) 1981 $5.12 BASE YEAR 1979 1982 $4.98 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE) 1984 $4.63" VALUE/1000 CREDIT RATE 1985 $4 .40 $0.00 x $5.29 = , $0.00 1986 $4.07 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $3.22 VALUE / 1000 CREDIT RATE 1989 $2.73 $0.00 x $5.29 0 1990 $2.25 1991 $1.80 1992 $1.59 TOTAL MWMC CREDIT = $0.00 1993 $1.45 1994 $1.25 1995 $1.09 1996 $0.92 1997 $0.72 1998 $0.48 1999 $0.28 2000 $0.09 2001 $0.05 Date fUN '-TY" rrITIALS "f'::rvv... 0 DATE I;()--OS -CJf I SOURCE 'CYl:{)"; r~ ~ l ~JoB 10, I 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 I 0 ELECTRICAL PERMIT APPLICATION ' City Job Number ~ 20-07 - 0/ '5'0/ 200 Amps or less , 20 I Amps to 400 Amps Address 31la.S'3 f3OS(AGf (,.10' SPRD ,401Ampst0600Amps VI"..E 601 Amps to 1000 Amps, Phone ~.l'-Vty)f9: Orel)Jo(Q)fawI~t!I_;Y8llSt ~I\;o tidopted~_I(!)Qcl.v.. 0 'Notification Centel Thos n:I\:IUn Utifity L I -In.0IA~~2~~;-00'1o.t ~ra.seHort Supervisor License Number, 1 (odgl!S. obt ~~ 1I.,~~ , Calling th aln c las of the rules bv ) 0 - / - 0 ~umber 4...~ 2.enoter. (~Qf&~.I~ttel9~_ t)r Relocation 'W--U/e regO~.IV^tif' . Center is 1-80 s'Q'M9slCation $ 55.00 .constt..Contr. Number { /777 0 0 m 0 1M Amps $ 76.00 I (] ~ / _ 09 0 401 Amps to ,600 Arrips II $110.00 Expiration Date 0 " ,I or 1000 Volts see HB abo,ve. Signature of Supervising Electrician D. , .' I,' '~J4 ~ ~ .1 I . ' OwnersName .ttV/H/Hld /j(j~ Address ? /-22.-1, C>5dAlY~.1 1 - I r'; City .. 'ksMJQ)1 Phone Pump or irrigation__,. ' $ 55.00 I Sign/Outline Lighting ! $ 5:5.00 , OWNER INSTALLATION NOT'CE~ Limited Energ~~l~~WliHE W~Q~ $ 28.00 The in,stallation is being ~ade on property I own whin.\IS PERMg;iS~-Ne~\tH~Err \S N01 $ 50.00 IS not mtended for sale, lease or rent. AUTH'0lill~Q ij~~~lJIA'r ij '0 is $5Q.,!l0 + Surcharges Owners Signature: COMME~i~li~~So "OJ'! , / 5)' ~' " ANY 180 M~. tate.surch;rge J /_ _"t... 10% Administrative Fee '/ 1::; tfJO 5% Technology Fee .. """ "or I . TOTAL, J j~ >7 Shared Drive(T:)/Building Fonns/Electn;al Pennil ApplicaliJi\7-07,doc 1. LEGAL DESCRIPTION: 17n2- z.'~~,~ CJ 2. Tt:TO . --- JOB DESCRIPTION: , I' s;e RCJ: I ~~~ Permits are non-transferlble and expire if work is not started within 180 daYs of issuance or ,if work is Suspended for 180 days. ' 2. Electrical Contractor E' (~S151 fj{2 (LfCTf( I (. City 5P\-co Expiration Date ">, Inspection 'Request: 726-3769 '. . i 3. A. Service Included , 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof , Each Manufact;d Home or Modular Dwelling SerVice Or Feeder I ' $11}.00 1(7 ~ $ 2t.00 ~'2-, ., I $55.00 B. $ 70.00 $ 83.00 $138.00 $180.00 $413.00 ' $ 55.00 , New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit ' $ 48.00 $ 4.00 E. .~ ~:,..:r' 225 Fifth Street Springfield;Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-0 150 I COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-0 150 I COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-01501 COM2007-0 150 I COM2007-01501 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: 2200700000000001553 Date: 10/05/2007 Description Sidewalk Permit Curb cut Permit PW Disc - 2nd Permit Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Reimbursement SDC Transpo Improvement Plan Review Major - Planning Plan Review Residential Building Permit Addressing Assignment Willamalane Single Family 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Appliance Vent Exhaust Hoods Dryer Vent Gas Outlyts 1-4 Heat Pump ~Mech Iss 2+ Appliances~ Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Fire SF Fee - Residential + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By SCOTT DAVIS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 02943C In Person Payment Total: Page I of I 9:06:27 AM Amount Due 85.00 85.00 (40.00) 644.46 644.00 489.70 95.35 990.39 10.00 123.26 73.32 195.48 862.25 205.00 549.12 844.80 35.00 2,303.00 280.00 14.00 21.00 7.00 10.00 7.00 5.00 14.00 40.00 117.00 42.00 91.70 84.84 108.94 145.35 $9,182.96 Amount Paid $9,182.96 $9,182.96 10/5/2007 Willamalane Park & Recreation District Job. No. Q14I'JJlJ7-0/50! SYSTEM DEVELOPMENT CHARGE WORKSHEET FOR 2007 NAME: (!tlJhd/hf/.{ //V~ PHONE: . ADDRESS:!1/22/ tJ~W:TYk~) STATE:.1{ZIP: 9'7U.r LOCATION OF PROPOSED BUILDING SITE: Street Address: ?3 ~ .~ I J T, ' Plat Name:]dHA_or.l3t' ,.P'~ Tax Lot Number: j 7 /J~ 2!JJef tJZ,1~ 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. Sinale-Familv Detached, NO. OF UNITS I X $2,303 per unit = $ 2-'3~s B. Sinale-:-Familv Attached , NO. OF UNITS X $2,426 per unit = $ C. Multi-Familv Aoartment NO. OF UNITS X $2,032 per unit = $ D. Sinale Room Occuoancv NO. OF UNITS X $1,016 per unit = $ E. Accessorv Dwellina Unit, NO. OF UNITS X $1,151.50 per unit = $ WILLAMALANE SDC $ 2. SDC CREDIT (If applicable) SDC payer must furnish proof of Willamalane Credit approval.) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) $J5t?:? ~~ Development ServiCe's Department City of Springfield /D / 5" I 07 Date 5