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Home My WebLink AboutPermit Building 2003-1-16 . Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line * . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2002-01417 ISSUED: 01116/2003 APPLIED: 12/27/2002 EXPIRES: 07/16/2003 VALUE: $ 12,408.00 SITE ADDRESS: 2568 MAlA LP ASSESSOR'S PARCEL NO.: 1703251404900 Springfield TYPE OF TYPE OF USE: Manufactured Home w GaragelCarport on Private !lieI\' Residential PROJECT DESCRIPTION: MH with garage Owner: ALLEN FOSS Address: 2568 MAlA LP SPRINGFIELD OR 97477 Phone Number: 541-868-0498 Phone Number: 541-868-0498 I CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone General HARRISON JACOBSON INC 66447 05/0712004 541-689-7762 Electrical RALPH W BROWN 63137 02/15/2004 541-729-1500 Owner ALLEN FOSS 541-868-0498 Plumbing HARRISON JACOBSON INC 66447 05/07/2004 541-689-7762 BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: 1 R-3 U-l VNSpr 3 # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: 1 15.00 'orced Air Electric Electric Electric Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 7,479 1,437 480 I DEVELORMENT INFORMATION' . ~~, ?$- ~.~ ~ . REQUIRED PARKING ;, ~~ l?g~~"" 10.00 : ~'<Sf Dist: !'o ~ q; C;S ;"'fotal: 2 5.00 " i~~t68 Trees ~ ~ ~., 1ff ~ ~ndicapped: 31 00' ~ ..red Dr' R d ;:; <i)J ~ 0:) ~ " ..0 .' ~ i,~ '&~ lVe q: ~O~ 'illsQ: 0 :!.."'l\Wpact: ~ q,v ~ ,," "p ",:r "" ~.~ 10.00 .s:. ~ -~ of Lot Coverage: ~ !!' ~.001 .;:' "q} ~ 23:00 <(l~ ~- ~ ~ ~ Ji!'oO q;:;p;:-: . -'(", .;f ,p ~ F-~ '" .S> $:~ ~ cf~fis:i~ IMPROVEMEN'F~"'t.~-~ <r...?!.~~1t L .'<S". qr 1:) 0~'" .~ --"" ::J . ~ .....<S' ~ S" S ~ ~:>s;.~ ~ Street ~. ~"""lif' _~ d ~ 'b',ff ~llI~aq< "'ipe:) ~ {Q~"IJY<<:,~....~e ;.:;. <fl (j ~ 0 ~ ~.<fi? Storm Sewer Available: _~ <l: ~,~ :<l' Yes tit ~ ~ <;:>~BwoSp6iit"'Drains Special Instruction: ~~~~lt~~<::is private. ~ ~ f 1ff ~ 0a-~ ;.!?? ,,~~~ '<t~~~d'~~ # Notes: 'It' & ~ "l: is O"t" ~. i" Ii; cJ 'It' ~.~~ ~~ "'(;5 (j,!f ~ SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Curbside 5' Curb and Gutter 1 of 3 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Desc ription Type of Construction Foundation Only Use Bid Amount Garaee Garaee Manuf Home Manufactured Home Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Addressing Assignment Annexed 1979 or Before GaragelCarport Manuf Home State Issuance Manufactured Home Connection Manufactured Home Feeder Manufactured Home Placement Manufactured Home Service Plan Review - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area WiIlamalane Manuf Home Private Total Amount Initial Review Plannine Review Public Works Review Structural Review 12130/2002 12130/2002 12130/2002 12/3012002 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2002-01417 ISSUED: 0111612003 APPLIED: 12/2712002 EXPIRES: 07/16/2003 VALUE: $ 12,408.00 I Valuation Descrintion I $ Per Sq Ft $1.00 $19.60 $1.00 Square Footaf!e 3,000.00 480.00 45,000.00 Value $3,000.00 $9,408.00 $45,000.00 $57,408.00 Date Calculated 12/30/2002 12127/2002 12/30/2002 Total Value of Project Feps P"il!J Amount Paid $85.02 $43.88 $30.72 $3.00 $8.00 $-154.06 $130.80 $30.00 $45.00 $50.00 $160.00 $50.00 $55.00 $386.17 $508.07 $10.00 $34.83 $332.86 $88.68 $47.43 $709.81 $160.87 $733.55 $1,000.00 $4,549.63 Date Receipt Number 12127/02 1/16103 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 ' 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1/16/03 1200200000000000471 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 1200200000000000566 , Plan Reviews , 12/30/2002 12/31/2002 01/0212003 01/1612003 APP LLH APP EMM APP DPE APP RJB Infrastructure is Private. 2 of 3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2002-01417 ISSUED: 01116/2003 APPLIED: 12/27/2002 EXPIRES: 07/16/2003 VALUE: $ 12,408.00 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. ~rtion'J I Erosion/Grading Inspection: After all erosion measures are in place. 2 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. 3 Footing: After trenches are excavated. 4 Foundation: After forms are erected but prior to concrete placement. 5 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 6 Shear Wall Nailing: Before covering sheathing with finish materials. 7 Firewall: Located and constructed according to plans. S Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 9 Manuf Home Set Up: When installation of all piers or stands is complete. 10 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. 11 Final Building: After all reqnired inspections have been requested and approved and the building is complete. 12 Storm Sewer Line: Prior to filling trench. 13 Final Plumbing: When all plumbing work is complete. 14 Manuf Home Plumbing: After home has been connected to water and sewer. 15 MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to the panel. 16 MH Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certil)' that all information hereon is true aud 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 ohny structure without permission of the Community Services Division, Building Safety. I further certil)' that only contractors and employees who are in compliance with ORS 701.005 wiD be used on this project. I furthetla roo to en re t t all required inspections are requested at the proper time, that each address is readable from the street th e' c rd is located at the front of the property, and the approved set of plans will remain on the site at all tim s . . ---. -........... ____ /-/6- 0'> Owner or Con ctors Signature --------.> Date 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number COM2002-0 1417 COM2002-01417, COM2002-0 1417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-0 1417 COM2002-01417 . . " 1/16/2003 1:24:17PM;. City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 1200200000000000566 Date: 01116/2003 . Amount Paid 8.00 1,000.00 50.00 ~ 50.00 3.00 55.00 733.55 508.07 . 386.17 160.87 709.81 332.86 34.83 (154.06) 10.00 Description Addressing Assignment Willamalane ManufHome Private Manufactured Home Feeder Manufactured Home Service Add, Alter, Extend Circ Ea Add Plan Review - Planning Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement Annexed 1979 or Before SDC MWMC Administration Page I of2 cReceipt.rpt iC~f ~, 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 COM2002-01417 Payments: Type of Payment Check Paid By Receipt #: 1200200000000000566 Date: 01116/2003 SDC Sanitary/Storm Admin SDC Transpo Admin Garage/Carport Manufactured Home Placement ManufHome State Issuance Manufactured Home Connection + 7% State Surcharge + 10% Administrative Fee Roeeived By Check Number Confirm No GOODEN HARRISON Page 2 of2 " ~, 1/16/2003 , 1:24:17PM " ., . City of Springfield Development Services Department Public Works Department Official Receipt Line Item Total: 88,68 . 47.43 130.80 160.00 30,00 45.00 30.72 43.88 $4,464.61 . Amount Paid 4,464.61 $4.464.61 How Received In Person Payment Total: cReceipt.rpt ~0~1;,- . fJ1.~,'li ''''. {";225.FIFTHS'fREET '; ,,\ \.~:.~eb.'<'iJ..'t::d.;':' E.CALP!ORMITAPPL*CA ION ,:.;, ,: "",l!\ i;1; SPRlNGFIELD OREGON 97477 ';"J'f"Vl , ;,.' > !.~ ,,' -,: ',':.(Y~T(;)rM,',,' lff' i " ,', : "~ ,<':. Il",)NSPECTIOi'! REQtmST 72G;J~~~ *, "" \:'Cit). Joh ~ill'11;C;'~{;:" . L: ':;"":':. , ",., , . ',', " ., eo 0""'" ,....~ ", - ".., - '-.,," . , ~"A :\.' "'l;", .."",p,'OFFICE 726-37)9.''''', O~;~".^" ", ,. ,.p , n'," ,...(1.'.,.,,'.'" ~ll""""l' t q~ l&"~""~~$ ,,!~ r, .....'4. ,~,~,.;,,,,,~,,,,.. '..,....<:.<....' "'''''1 ;;:1 J};; '; . " :;,,,,,";:,', .; 0::,:, '~"" 1;,'00, ~'r :if, _.<. :.COMPLETE FEE'SCHEDULE BELOW",:' ";<','i;'c "~"'. .I> - i~ -!k~! G In li>{:q~~~~ i ~: ~ "'t;~ [f;;') ~~iJ;;' t.~.:, ;;~;.i'i,~'::~i;;:.J~::~;:~<</.';::~':<p.: :.~;: ..' .1~ '---'lnA ~ - .0 ._---. 'A. ~ Ncw'Rcsidcntial;.Siriglc or"~""~-""';"'." -:. -.. .... ..... .k ". LEGAL'DES~RlPT~~Gl ~ <",<f"'" ~~~~~i~:~:il~:'~; dwclling unit. 't;~tf Il(J3~~l4: L~~ Items Cost Sui't;.,:, . ~. .Y. ~:~ .~,,;' . , ". '.~;i,':..:,',',.~,' ~DESCRJP'fiQN(' ~ ....,.1 r::., " .... 1000 sq.ft. or less , .,' .Y"\ J , u.J ,,\ I.. - ~_ Each additional 500 !*,~~\ Permits arc I:,)transferable and expire :I;~~:: portion :~> if work is not'started within ISO days Each Manufd Home or " ' ~~~S~l~~,~ce .?: if work is suspended for ~~~~:~:r o~;~~~~~ +i',., .'~ 50,00 i.f/!) ~ ..":<~. :~.:r~ ,>:~~,;,.."F ",.. ~..~:?,' ,'... 2, CONTRACTOR INSTALLATION ONLY B. SCI'\'iccsol'Fccders ,::' >:;': ..:':::'. ,';::: ".i'~"',~ ':"':'~ ,.oJ? .' Installation,Altcrations'otf .."-'\-..,,:. :-::~,' ~ " , { \;.. ~ u( ('"', ., ~ ~ (. . ~, .~' ,. ~ . ,I:~ ~{" Electrical Co~tractor > _ < LU Relocation.. ~:~ \~y:."~:r-~:' ~ ,'~::,:.';t '::~~,:"5%\,., "..l-,~;".( "'''' ,~".. ...... 1.~'~ ,,~:. ~">. .l..,~ ~ "" " r.' ~:>\1"', " J ....:-~ ! . , ~ ':~..A' <{ CV.. ~~ t:t~- /t,,\;.,\ ~'J'~~' t...."\;..l~, ~H-:...",. ;-:~t" r,;.;::~"i Addlcss. ~,:,\' .:-<~/~ . _~ -=~j,:;:;':+l 200a111psorles~~''';,....:,o~~C?~ :~~ . ~~:$.63.00 '.~ ""~..\ L;".< ?J:.""" ~-,.' ..;:...'>.,:.~f''''';''~" 201ampst0400all1~i.,,\~~'l;.Y" :..$'75,00 .'" "~.~-- '" ,.~ 7<JG21~(J7\.~-.... (\n.~\ ^V 'IO"\.\:~ '>-. '-J l~:':,'," City ...'~~...;:PllOnc ~7;,-;;r:P,!,<,;J/,,,,,.. '';' 40] "mpsto6~~lDaO\':o.\' t'\~$125,OO ' ',' , "'t'" " ' ",,: c.' '" , " ',' . ,,~" ' . "'''C'' ',' .At) ntA(<l,-" >,;'i>~ .t'\'v ,..' ," . .,~~ \\""~" ," "",A' ',,' ,I: t:">liJk-";-.." 'ii:"; ~"'GOl amp'~ to-.-lO~ll;p~~v. l:J~A.l ,~,$163,OO, . ~-' tt";~'~';: SllPcr\'is6';--Lic~i;se'Nl;n;b~; "7 ,T-'=>'i-:>&;' .;~,"{,c~~o\,qeJ:>>O~" '/~\5'O,,;~q;. ,,~e'i> . " ,.' $.175,00;",-.;,: , .';"f.j:,.~ : Q.';,.,.. ~:~{.~'''' . '.. ~--.l""'~" .t' :'[.t:~....",~ -~.~~ ";AA:"} l?i"0""i''',^~' :.~ ~----:-:-~i ~'-.'"e~ ~""'.~"",-~'_f.>-,..,1~7 ..:..-v...... -"'}-:1'<:~.: ~.t.~~....1\0.K'e,01J~:~ fWry-....~~ ..~~.. ~O\~..$..50.00 '..~~:.. k':1fl ExP!r,atHi~' D~i€' ': ;;(87 0<1 ~~l"~:: {,,~:: ~ ~f\t.~\~",~, ~~~;~,~~~?-. '~~9. \~e~~~~i .,~. ,,~'i:P'~~?:'~"jt ~{,';~; 1;/"/'''':: 1'~ ~7" ':, 1': "t:'" i' ;,tJf!; '\; '; ',":':, l:\C.WF~)1Jp;6,j;\\r>; SI!J~'i~~~0~~r~o\\~~,. : \/". ;;P,;"?'<,"i,~:';;~: ~fk;:~t Co~st; CO~l{;:Nll;!,bJ~";4~ 37' /@,<.lf~" ~~]ti~P.lilat@.n~~11~,!lill~:o.;,~~IK(i1!~~:i;~';f!~~i~i~'~~';;'~~; I: 4"" . '.~-'.:t 'e," ' ..,.. .,,~, '\, -" ~,w,'i:..('o"'c'~"""'1'" ""eV'~..;..,^','-1",t')"W,,,.< .... .. ""k..k~' ".i" '>\1:1";: ,;.-":",~.f,,,'. ....:.:7;,;...\.........,., ',', :V'.:t?;_,.".-. ,-;t..~ ' .ft....,.~~.~\"..~ 'e."''': .-.~VY';n..~"'" .~r-j?\y.:' -r ~\.;;.f:~:~'-::"" ~'-t>'\J,'.f.t~w ~~:; ;"::-'t~4\~'Expiration Date /d '/ lLX:-;,::-~ :;..,....,' ' .:~O~;7{lQoo~fih cm~s":@::-'..' '.,:;;; .': .:";:'{:'" ;;$50,00':'," ',~ >'f;<..: 7'i'Z1''''/~ ...\. I -'rl~.........>, r~\t\.\~ n.."'!Jv::..<.' ^""\;.-,.~~'V;!t.'O. '~..-g...~..l,i.t :..""'. .'. -"'\' "'...... .:- ~\--::--:- ;.'; .;,..'.rf.' .:.'..",,", ,,' :t:ti.";'';-';''''v.A,,\\\llO'l aWPS.to'(l.O.v.aplpS"... "~,"" ~1$69,OO,: .'. " ,~t~_.!',t~"...il.. ---....;,:.'-J~c~ ".<.' "p.\: -''''_~'' ~!....... ,. '.1".-- \~4r.::,\~'~~;r:~.. Signature of SUJlcn-ising Electrician ~,... ~A.~erA~\to 600~amps:;,.\>'~~1'~ ""+.' .-:;.;; &$100.00, ;~: A.x:: . . ~,;"-~""....>--,' . , ,N4".... ^'~,.\ l); -',!:> - "'~Y', '" .'- .''''t.:< "1".:' ~"'....- ~,..:_t .~:~rs;;,,~] ;:' ...;.:~.~;", ~;~'''-,__ ,. Over 600 amps or 1000 ."olts.see::"'.\1':'U'.:"~~;t,':.;'" ,.~~"'.,~1/, 'J .'" -.(........, '.~.._~,'. "'.. ....~ Puu ..,~. '-"'<l- ~ \~",.""".'-.~..". t....,t, . t:h~~:':"i' 3'. -:~ .:...: i ~..~, I J "B" nbove ..._,..~ ~'" "-.. ",r<~\"f;!~"_~ .J;~ ,7."-.""';. t~'I'-~.".'~;'1"'(''''''';'~. ' , :~<?...U/.. IV<.... < "'- --,,,..",:,,~:~)-:;>."';....,;:,..:.,~,.., It,,I~'~J,:~...~.,'''' ,'~. ,.'. ~'~';~"r ~,' ',..' .~I:"'~iJf--\;:tr'~ ,~ t';~'-l~"-t......, ':, _'~ ,';': "t-~",' " .~t~.". ........--::.~.l..._~::f<'i..::"i'>;-::~~, ~. .~1;,"J}~ll;.,\\~.,.'....~,'.., '~I"::.~. .f~:',:-. .~.: \sS D, Branch CircUIts : ,.j?v\"~or,,~t. "fl ;.......": .,.~~.~.....,,~ .,~ -..: "AT'::"': .. (), " . ~~, 1r'1",t;~",..;:.r'f" ,...-,.; ". ~,: :":~\t. O,vncrs ~.~ . .. Nc\\ Alterati~r Extension Per Panel .'-:.X;\: '~1\::.(>"t'... ~f<:;;';~':!:~':',"1,j. ~'"Yf:\~~~B' .i~c,;I -" . ~:'~~~10 <\-1.J''::, " . ';:;;: :~r:;'(::1 ".~;~t : ~,:~O'~.:', Addres~C<J~': \..A\fN~, f'J.--./ On<;-~nlliJC..~\I, . i , ..; :$43,00 "~"<:':",:' , ' ~"~f"'',:, ,...~" , 'r-,ii\ ::,., '. ~ h. y.;..:..Q ~cm ~~\"{ ~'\\~~ ,c.' -::-,'--;:. <:c:;-;-.. ( ',?'::<: i, "Ci ' \U' 'Ji:" Yhon~ tJ~\/.;,l..1.n V ~{<,~,!f\..~~~nal C!icuit orwith SerYi~;'.~' :< :' !i3'~~ \.: :..., 'c ". ' , ..: , j.',': . ~>r-"" ,\~r~r Fennit . . + $ .3.00' l;,A;..I " " .. 0\ E I TALLATION "" ' ~~. ~ S ~~y.:~ >r-~~' ,', .: ' 'The installation is being made on"~'\'\ ,,?y.:~~ y':'V ~ ~ .,qi~)lancous (Scl'"icc/fceder not includcd) . " ., .. property Io\\'O which iS,not intencn,i.!:~S ,,,'V~1) 5:JY.:'V oy.:~\S ,Each installation " ' , ' ,', for sale, lease or rent ' , ' ~'0'\" ~y.:~ 'V~ ' Pump or Irngatlon ' _ $)0,00 , .' .' " . \;\)~ \'0<::1 Sign/Outllllc Lighting $5000 OWllcrs Signaturc, >r-~-4.. Limited Euergy/Res $2500 . .' _ Limited Euergy/Comm $-15,00. $10G.00 ---?-2- . ;';";:; ,~, ' , .-:':~),: ~:. ~.-: $ 19,00 ,_...... 1\linimum Electric PCI."mit.,Inspcction Fcc i~ 545.00 + surcltl5 4, SUBTOTALOFABOVE ~, . 7% State Surcharge 1.....'b.\ 8% Atlministrati\'c Fcc B .~~ HA.4 'S TOTAL .' . . MANUFACTURED HOME LAND USE AGREEMENT 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX(541) 726-3689 As required by the City of Springfield Development Code, I agree that..\"il/1 th;_ app!jl'(al ofJhe al!q,.ched permits, one of the following manufactured homes will be placed at ..I..~"C\. It-l~, '^~ Springfield, Oregon, City Job Number ~-(l)U-ll.' ~ Type I Manufactured Home. A multi-sectional (double wide or wider) unit with an enclosed floor area of not less than I ,000 ~quare feet, that has a nominal roof pitch of 3 feet in height for each 12 feet in width, that has no bare metal sidingor roofing, 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 11 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 roofmg. The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6 percent slope wi~in 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 n.o more than 24 inches of the enclosing material exposed above grade. I further agree to meet all land use and City Code requirements of the 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 andlor 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, . Fiiial lot grading . City Sidewalk and curbcut installation . Any outside ~gency approval as required Le" Division of State Land approval. By my signature below, I agree to complete the above mentioned land use requirements. Date .._~ ~ /-/~- 03 -....-........ Contractor Signature - Date ...-'. . -~ CITY OF IINGFIELD SYSTEMS DEVELOPMEAoRKSHEET JOURNAL OR JOB NUMBER: COM2002-01417 NAME OR COMPANY: Allen Foss LOCATION: 2568 Maia Loon TAX LOT NUMBER: 17-03-25-14-04900 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 1917 LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S,F, x I COST PER S,F. CHARGE I 2601.24 I $0,282 I = I $733,55 I 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 DISCOUNT I 0,00 I $0,282 I I 50% I = $0,00 ITEM 1 TOTAL - STORM DRAINAGE SDC $733.55 , 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I COST PER DFU I 23 I $22,09 B. IMPROVEMENT COST: I NUMBER OF DFU's I x COST PER DFU I 23 $16,79 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , 3. TRANSPORTATION A, REIMBURSEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I I 9,57 I I I B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I I 9,57 I I I ITEM 3 TOTAL - TRANSPORT A nON SDC $894.24 x I COST PER TRIP x INEW TRIP FACTORI I $16,81 1.00 x I COST PER TRIP x INEW TRIP FACTORI I $74,17 I 1.00 = , $870.68 4, SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I I I $332,86 B, IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 1 I $34,83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD< SUBTOTAL (ADD ITEMS I, 2,3, & 4) 5. ADMINISTRATIVE FEE: ISUBTOTAL I x I ADM, FEE RATE 1= I $2.722,10 I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: 5twt- ~ 1/2/2003 PREPARED BY DATE 7479 $733.55 $508.07 $386.17 $160.87 $709.81 I; 10 18 10:: ItJJ E- -/~ o ~ 1070 11091 I 11092 11093 I 11094 = $332.86 I 1054 I = $34.83 1055 ($154.06) 1054 = <.... . . ;,- DRAINAGE FIXTURE UNIT (DFU) CALCULA nON TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAlNAGE FIXTURE UNITS (NOTE: FOR REMODELS. CALCULATE DNL Y THE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 = 6 IDRlNKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 1 0 2 = 2 ICLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBlLE HOME PARK TRAPJl PER TRAILER) 0 0 12 = 0 IRECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 IRECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER. SINGLE STALL 0 0 2 = 0 ISH OWER, GANG (NUMBER OF HEADSt 0 0 2 = 0 ISINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 ! ISINK: COMMERCIAL BAR 0 0 2 = 0 I ISlNK: WASH BASIN/DOUBLE LA V ATORY 1 0 2 = 2 I ISlNK: SINGLE LA VATORY/RESIDENTIAL BAR 1 0 1 = 1 I URINAL, STALL! WALL 0 0 5 = 0 I ITOlLET. PUBLIC INSTALLATION 0 0 6 = 0 I ITOlLET. PRIVATE INSTALLATION 2 0 3 = 6 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 23 I. ,~DU (Equivalent Dwellin~ Unit) is a discha~ eQuivalent to a sinJ:!:le family dwellin~ unit (20 DFU's) set al 167 gallons per day MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 ]989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT RATE/$I,OOO ASSESSED VALUE $4.92 $4.92 54.83 $4.77 54.64 54.47 54.30 54.09 S3.78 53.41 $2,98 $2,52 $2,06 $1.64 $1.45 $1.31 $1.13 $0.97 $0,82 $0,63 $0.41 $0,22 50,04 IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT? (Enter I for Yes, 2 for No) BASE YEAR o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $31.31 x $4,92 = , $154,06 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $4,92 o TOTAL MWMC CREDIT = $154,06