The URL can be used to link to this page

Home My WebLink AboutPermit Building 2005-10-14 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax , 541-726-3769 Inspection Line -. . CITY 01' ~rKll'\jut<lJ!,L1J . Building/Combination Permit PERMIT NO: COM2005-01326 ISSUED: 10/14/2005 APPLIED: 09/28/2005 EXPIRES: 04/14/2006 VALUE: $ 49,000.00 SITE ADDRESS: 1155 Laurel Ave ASSESSOR'S PARCEL NO,: 1802064200200 Springfield TYPE OF WORK: Manufactured Home on Private Lot TYPE OF USE: New Residential PROJECT DESCRIPTION: Manufactured home on private lot Owner: DAN MATHIS Address: 4560 LIBERTY ST EUGENE OR 97402 . Contractor Type General Electrical Manuf Home Inst , Plumbing Contractor OWNER OWNER JERRY OTT OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Sethack: Side 1 Sethack: _ Side 2 Setback: - Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: 19,00 5,00 Phone Number: 541-688-5175 . NO~.~t"~RACTOR IWiO~ORK lHIS pl\{I'I1Il"~ . ~R.~lT IS NOT AUTHORIZED UNDER lHIS PONtO~R Expiration Date COMMENCED OR IS ABANO AM" 1. 0I\'f PiRlOD. Phone 69455 09/26/2006 541-935-2696 BUILum", mrvNvlATION I R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: nla VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: , DEVELOPMENTINFORMATION I REQUIRED PARKING Total: 2 Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Urban Fringe 3 5,00 12,70 quireS you to . ._~......It.I. f"\..onn'1 taw fe . .....~i I PUBLIC IMPRov~ilSr;S'I';s adopted by the UI l"aY;;; ~;t'i~rth '! n1E.r 'Those ru es Notification ce's.we"'''~i~):p.e:' OAR 952-001- AC M~~ in OAR 952-00k~ . :mtsi6~a'i'~~\1e rules by 0090, You ma'j -,nsp Note: the telephone calling the center, (on Utility Notilicatlon number lor the, 01reagOO_332-2344), Center IS - Notes: Storm drainage piped to drywell 9/3012005 CAS Palle I of3 . . Ltl:f OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01326 ISSUED: 10/14/2005 APPLIED: 09/28/2005 EXPIRES: 04/14/2006 VALUE: $ 49,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line I Valuation Deserintion I Description Tvpe of Construction $ Per Sq Ft or multiplier S1.00 $1.00 Square Footage or Bid Amount 4,000,00 45,000,00 Value Date Calculated Foundation Onlv Use Bid Amount Manuf Home Manufactured Home Total Value of Project $4,000,00 $45,000,00 $49,000,00 09/28/2005 09/28/2005 ~ ]?pp< tIiILI Fee Description Amount Paid Date Paid Receipt Numher Plan Review Residential $39.39 9/28/05 1200500000000001420 + 10% Administrative Fee S51.96 10/14/05 2200500000000001427 + 7% State Surcharge $36,37 10/14/05 2200500000000001427 Addressing Assignment $31.00 10/14/05 2200500000000001427 Fixture $14,00 10/14/05 2200500000000001427 Foundation Permit $60,60 10/14/05 2200500000000001427 Manuf Home State Issuance $30,00 10/14/05 2200500000000001427 Manufactured Home Feeder S50,OO 10/14/05 2200500000000001427 Manufactured Home Placement S160,OO 10/14/05 2200500000000001427 Manufactured Home Service S50,OO 10/14/05 2200500000000001427 Sanitary Sewer - 1st 50 Feet $45,00 10/14/05 2200500000000001427 SDC Sanitary/Storm Admin S18.30 10/14/05 2200500000000001427 SDC Tran8po Admin $49,42 10/14/05 2200500000000001427 SDC Transpo Improvement S805,70 10/14/05 2200500000000001427 SDC Transpo Reimbursement S182,69 10/14/05 2200500000000001427 Storm Drainage Impervious Area S366,04 10/14/05 2200500000000001427 Storm Sewer - 1st 50 Feet $45,00 10/14/05 2200500000000001427 Temp Power 200 amps or less $50,00 10/14/05 2200500000000001427 UGB Plan Rev Mj/Min - Planning $203,00 10/14/05 2200500000000001427 Water Line - 1st 50 Feet $45,00 10/14/05 2200500000000001427 Willamalane Single Family $1,000,00 10/14/05 2200500000000001427 Total Amount Paid $3,333,47 I Plan Reviews I Initial Review 09/29/2005 09/29/2005 APP DJB Plannln!! Review 09/30/2005 10/04/2005 APP TAJ Tree Fel1ing Permit is required if more than 5 trees with a dbh of 5" or greater are felled, Public Works Review 09/30/2005 09/30/2005 APP CAS Storm drainage to drywell 9/30/2005 CAS Structural Review 10/13/2005 10/13/2005 APP DJB Pa!!e 2 00 . . CITY OF ~rKJ1~lJl'l~LD Building/Combination Permit PERMIT NO: COM2005-0I326 ISSUED: 10/14/2005 APPLIED: 09/28/2005 EXPIRES: 04/14/2006 VALUE: $ 49,000,00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. ~lJir,"rlln~n..dinn~ I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Manuf Home Set Up: When installation of all piers or stands is complete, Final Manuf Home Set Up: After all required Inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc, have been installed, Line to Septic Tank: Prior to filling trench and required testing, Storm Sewer Line: Prior to filling trench, Water Line: Prior to filling trench and including required testing, Drywell: Engineered Drywell is Required, Provide the City with a copy of the DEQ application to keep on file, Manuf Home Plumbing: After home has been connected to water and sewer, Temporary Electric: Approval required prior to Utility Company energizing pole, MH Electric: When blocking, setup and plumbing Inspections have heen approved and the home Is connected to the panel, MH Service: Approval required prior to utility company energizing service, By signature, I state and agree, that 1 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, . ~~ A:J -/'7--- (75' Owner or Contractors Signature Date Page 3 00 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 ELECTRICAL PERMIT APPLICATION w!p~~~.'~:~~'JI.~~.~...~~~ 1. ~...II2~qE..~~,~!.I'~TI.21)'.a1l:~ljj'~ /I ')) LA-.A,re- ( A J LEGAL DESCRIPTION I &""0 LOb '-(L c:> 02.C>O JOB DESCRIPTION tM H eLc-C-'t-iU-(,A-L t TEM ~ Permits are non-transferable and expj. if work is . ;. not started within 180 days of issuance or if work is '. Suspended for 180 days, .' . . ~CO'~CfoRftNSTALBAiioN?m.i?l. . . 2.. t:~~""";":~:C>'A~""'-;'~'-~~-~~~-'{'. -'.'. -- 3, A, ~~;';R~=~i~~eii~i.;j~fi~~~~~~Wf1i~~i~.\l iC...".):~.dl!lij~~Qa< -. - - oQv.~':':i'.;l;l"~,,"~~~'W:V_\~w;-Zi.;~~~'J; Electrical Contractor 0 ~Nt'RL Service Included 1000 sq, ft, or less Each additional 500 sq, ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or F e~der.. S106.00 S 19.00 z.. S50,OO /00 . . Address City Phone Supervisor License Number / / ReconneclOnly tf~~r:;.~~.:~ .~ 'J':,;;..::t<"'Tty......... f: ,{ 'k9\-"'~.' <,",,,,.' -, \ i: .I,~1.'.' .:11 .~'. ~T.~~RQt:!!Y~~~!~~S~.rJF~,~_d~ry.<, .r:!.:(.~;j~~~r'~~,~.q;f~. ~:~ ' Expiralion Date constr,Contr,Num~ Expiration rvt . . Signatu:Z~:Pervising Electrician Installation, AIte,ration or Relocation I S 50.00 S 69.00. . . SIOO.OO S"o 200 Amps or less 20 lAmps to 400 Amps . 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, . ~~...~~'i';;;~,,~.,)i;,~~~~~,,:"r'Y'~~1r;';;:W:"iI.d":;:...,lP"";' "<.. ,,&~ D. ~1l~tfi1c]:~9_~_r~.~~ts~~~~~~~d.:::i:'~"7;i:',~./ffA~~~'Wi) ';Q,-'~~:l~ New Alteration or Extension Per P~,\'ll "OU \0 . o.UIII:: '\)\'I~ One Circuit \'3-,,1 Ie e':,nfl 'S:\~qo Each. Addition;V,,~i!}:U1~~r~f4i'e 0\ '3le set \~n.,,-, """'-- A A_ I ( Servu:e",~~br !(R,"\1l1t'O se 1\,\eS ;f n'O$:"~U" OwnersNarne JJ N M,.,..ln-l ~ P;\'''','Il\es'3 eJ"\\'Io u~~Ot"-lu\es?' Address I' oC'" r- I A . _ ......' A... / E, ~~~':iiiifi~1fo~~~)ffi~~f.;ji(i~~'t1;)j~.[j~;'iiift~il:f;[~1jiJ ~ "> l~'''' ,<Tv ,-' ~\l"""""':2.'GI:\:I~".cv.\"~:'\\'ieo\tll"'~e(\==-;;n oc/ _ ,- , nf>.?o 9'5 '3~ 0'0 I~o\e',. ~O\\IIC SO? p-:\ Phone b a tl . 'S /7 ) pUnlP'<lfQ~li~tiblP cefl\el, , fI I \\I\I\~ . ..)~ 50,00 Sign/e\lilU;~\'''4g\''filf,~\'Ie Ole~~()_",'2>'2.,'t..:,-. S 50.00 C'" , -101 . '\_~v Limited t.'!.~)\'ReJ\\~Qtil1t S 25.00 Limited Energy/Commercial S 45.00 City OWNER INSTALLATION The installalion is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Minimum Electric Permit Inspection Fee is $45,00 + Surcharges 4, ~sUBrofALjPKAB'o;~i$;ltJf.~I;f~~*-'i1 ~':~:;\'!~~',}~!<'.:':W- _~~~"K~~;I' .",', ,\~...,.~<,..,~.~Jl / S-O &- ~ ...j"_....-~ 7% State Surcharge. 10% Administrative Fee I SQC> Inspection Request: 726-3769 TOTAL Shared Drive(T:VBuitding FonnslElecu;cal Permit Applic:l.tion 1-03.doc I), , . \. ../ ", .' . , . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: CO,^", 'Z..~ - 0 I 'Sz..b . <} (-'Q\\o\lol~A'= Address: 1/ S;~ L~V\.rc:r\'\ ,~\lS~ V Issued by: ~ (] Date: ~/o.r Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701,055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued, This statement is required for residential building, electrical, mechanical and plumbing permits, Licensed architect and engineer applicants, exempt from licensing under ORS 701,010(7), need not submit this statement, This statement will befiled with the permit, Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: irl. ~2, I OWD, reside in, or will reside in the completed structure, I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion, o 3A, My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board, OR ..er 3B. I will be my OWD general contractor, If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board, If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notifY the office issuing this building permit of the name of the contractor, I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~ /'7}A!--' /o-/y-oS' (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner .doc 06-0 \-04 A~tin'g'as..ftur (}wn General C!tractor? I' '. : / \ . INFORMATION NOTICE TO PROPERTY OWNERS \ ,. ABOUT CONSTRUCTION RESPONSIBILITIES , ' \ NOTE: This Information Notice to Properly Owners about Construction Responsibilities was developed by the Construdion Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature, If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns, Employer Responsibilities You will, in most instances, be ruled to be an ~'employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure, As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid, You will be liable for the tax payments even if you don't actually withhold the tax from your employees, For more information, call the Department of Revenue at 503-378-4988, Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes'- on the wages of all employees, For more information, call the Oregon Employment Department at 503-947-1488. .~ The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsDav.htmll for the appropriate forms, Workers' Compensation Insurance: AI; an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees, If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U,S, Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages:-,.... You will be liable for the tax payment even if you didn't actually withhold the tax, For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at www.irs.llov. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone, , --- ., Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor; to coordinate the work of rough-in and finish trades, and to notify building officials as the ypp' UP' ;ate times so they can perform the required inspections, If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052, Property _ owner.doc 06-01-04 . . MANUFACTURED HOME LAND USE AGREEMENT As required by t1ie City of Springfield Development Code, I agree that with .!!'e app[oval of the allac.h~ permits, one of the following manufactured homes will be placed at IL 5S Ll\1A ~t!!' /'I\'J E Springfield, Oregon, City Job Number COtNl z.oe.r' . 0 ''3T b . . -K. Type I Manufactured Home, A multi-seCtional (double wide or wider) unit with an enclosed floor area of not less than 1,000 square feet, that has a nominal roof pitch 00 feet in height for each 12 feet in width, that has no bare metal siding or roofmg, and that has been certified by the manufacturer to have an exterior thermal envelope meeting performance standards which reduce heat loss to levels equivalent to the performance standards required of single family dwellings constructed under the State Specialty Codes, _ Type II Manufactured Home, A unit of not less than 12 feet in width with an enclosed floor area of not less than 500 square feet, that has a nominal roof pitch of2 feet in height for each 12 feet in width and that has no bare metal siding or roof mg. . The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6 percent slope within 10 feet of the perimeter enclosure. The perimeter foundation wall surrounding the home shall be constructed of stone, brick or other masonry materials, and with no more than 24 inches of the enclosing material exposed above grade, . I further agree to meet all land use and City Code requirements ofthe above mentioned parcel within 60 days of the date of issuance of the manufactured home set up permit. These requirements may include, but are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on your approved set up plans and/or permit and your partition approval if applicable: . Street Trees . Paving Driveway . Minimum 32 square foot storage structure . Completion of partition approval . Removal of any existing structures as noted on your partition approval . Signing and recording of any required partition, easement, improvement agreements, etc. . Final lot grading . City Sidewalk and curbcut installation . Any outside agency approval as required Le" Division of State Land approval. By my signature below, I agree to complete the above mentioned land use requirements. )(.tf2. ~ Owner Signature /fJ -ff-oSDate' Contractor Signature Date CITY OF aNGFIELD SYSTEMS DEVELOPMEaORKSHEET JOURNAL OR JOB NUMBER: COM2005-0 1326 NAME OR COMPANY: DlID Mathis LOCATION: 1155 Laurel Ave TAX LOT NUMBER: 1802064200200 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 1782 LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE I 0.00 I SO.323 = I $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S,F. I x I COST PER S.F, I x I DISCOUNT RATE I I I 2266.50 I I SO.323 I 50% ~ I ITEM I TOTAL - STORM DRAINAGE SDC '$366,04 I 2 SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 0 I COST PER DFU S25.07 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 0 I S19.07 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , ,1. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I 9.57 I I NUMBER OF UNITS I x I I I I I B. IMPROVEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I x I I 9,57 I I I ITEM 3 TOTAL-TRANSPORTATION SDC = , 16623.9 [ ~ rFJ a ~ DISCOUNT $366.04 $366,04 I 1070 $0,00 1091 $0,00 11092 I SO,OO 1 COST PER TRIP S19.09 x I NEW TRIP F ACTORI I 1.00 I $182,69 11093 COST PER TRIP I x INEW TRIP FACTORI S84.19 J I 1.00 I $988,39 I I I 1094 $805,70 4. SANITARY SEWER - MWMC I -I A. REIMBURSEMENT COST: INUMBER OF FEU's I x I 0 I ICOST PER FEU I S82.03 B. IMPROVEMENT COST: INUMBER OF FEU's I' x ICOST PER FEU o I I S865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL-MWMC SANITARY SEWER SDC =, SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , 5 ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE I~ I S1,354.43 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: = $0,00 1054 = $0,00 1055 $0,00 I 1054 $0,00 '11056 SO,OO I $1,354,43 -' CHARGE S67.72 18.30 1079 S49.42 1078 I TOTAL SDC CHARGES = I $1,422,15 9/3012005 Cheryl Slaymaker PREPARED BY DATE . . DRAINAGE FIXTURE UNIT (DFU) CALCULATlO.N TABLE, NUMBER OF NEW FIXTURES x UNIT EQUIVALENT - DRAINAGE FlXTIJRE UNITS (NOTE: FOR REMODELS, CALCUl.A TE ONLY TIlE NET ADDmONAL FlXTIJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUIVALENT UNITS [BATHTUB 0 0 3 = 0 I DRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE lOlL 1 SOLIDS 1 ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND I AUTO WASH 1 ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER 1 MOP SINK 0 0 3 = 0 CLOTHESWASHER - 3 OR MORE SEA) 0 0 6 = 0 MOBILE I.IOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG 1 WATER STATION 1 ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK 1 DISHWASHER 1 ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG Q'NM!lER OF HEADS\. 0 0 2 = 0 SINK: COMMERCIAURESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 IS INK: WASIl BASINIDOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 0 0 1 = 0 I URINAL, STALL! WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE.FIXTURE UNITS 0 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to 8 single family dwelling unit (20 DFlJ's) set at 167 RRllons per day MWMC CREDIT CALCULA TlON TABLE: BASED ON COUNTY ASSESSED VALUE CREDIT RATE/S I ,000 ASSESSED V AWE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE 1 1000 CREDIT RATE so. 00 x S5.29 ~ , SO.OO CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE 11000 CREDIT RATE $0.00 x $5.29 = SO.OO TOTAL MWMC CREDIT " I I _I I I ! I I I I I I I I I I I I I I 2 II I 2 o '{' , . ~.J:'!F!.~.~_'? ~.-. .. '1.., ~. . "~ i "" " ~.~---- ,.,.._~ ~ty of Springfield Official Receipt .evelopment Services Department Public Works Department 225 Fifth Street " . Springfield, Oregon 97477 541-726-3759 Phone ; . Job/Journal Number COM2005-0 1326 COM2005-01326 COM2005-01326 COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 , COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 , COM2005.01326 COM2005-0 1326 COM2005-01326 COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 COM2005-0 1326 CbM2005-01326 COM2005-0 1326 Payments: Tl'pe of Payment Check :i .. , '~ , :: ~ 10/14/2005 RECEIPT #: 2200500000000001427 Date: 10/14/2005 Deserlpllon Storm Drainage Impervious Area SDC Transpo Reimbursement SDC Transpo Improvement SDC Sanitary/Storm Admin SDC Transpo Admin Willamalane Single Family Addressing'Assignment UGH Plan Rev Mj/Min - Planni!,g Manufactured Home Placement Manuf Home State Issuance Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feet Storm Sewer - 1st 50 Feet Fixture Temp Power 200 amps or less Manufactured Home Feeder Manufactured Home Service Foundation Permit + 7% State Surcharge + 10% Administrative Fee ",. .' Paid By DAN MATHIS Item Total: Check Number AuthorIzation Received By Bateh Number Number How Received djb 99 In Person Payment Total: Page I of I 8:34:38AM Amount Due 366.04 182,69 805,70 18,30 49.42 1,000,00 31.00 203,00 160,00 30,00 45,00 45,00 45,00 14.00 50,00 50.00 50,00 60,60 36,37 51.96 $3,294,08 Amount Paid $3,294.08 $3,294,08