HomeMy WebLinkAboutPermit Building 2006-8-29
-~
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2601 MAlA LP
ASSESSOR'S PARCEL NO.: 1703251407300
.
.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-00967
ISSUED: 08/29/2006
APPLIED: 07/31/2006
EXPIRES: 02128/2007
VALUE: $ 18,700.00
Springfield
TYPE OF WORK: Manuf Home w
Garage/Carport Private Lot
New Residential
PROJECT DESCRIPTION:
TYPE OF USE:
Manufactured home and garage on private lot
0\).\.'-'
JACK AND SANDRA GARDNER teC\\lI\es'l \)tl\II'I
893 S 44TH PL 001a'/'J O\e900 \0(\.\;\
SPRINGFIELD _C?~;,(..\t~8 ?:~~ecl '0'1 1:'~,'les a\~ ~~;__OO~-
t'. . \ ~\J.\C'="''''~ Br \ \ \V- _. ,,,n UI""" ..\ \\eS U'1
\L~~~().\100 Ce0\h<;:ONTRAC1;OR-INFORMATION I
",~".I. 052-00'1 :Clalll v-, . l'fIe ,,,'-:' \10\1
",,,,\,\ ~ a" 0 1~IO\e' "oll\lca .
con!J:~ct,IifJ ('(\ ':"nlel. \I~~ tllll'l'~ LIcense
HAR~~~Q~JA'Cg,"S.9.N\IN<:~32_2?AA)' 66447
ROBS-ELEGrRIC INC~ _\\00 156678'
~"r\\u"'-. _~p' \'"
HARRISON Jl\eOBSON 1NC 66447
Owner: '
Address:
Contractor Type
General
Electrical
Manuf Home Inst
i.,
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
10.00
5.00
5.00
30.00
0.00
Street Improvements:
Storm Sewer Available:
Special Instruction:
BUILDING INFORMATION I
1
R-3
U
VN
# of Stories:
Height of Structure
Type of Heat: orced Air Electric
Water Type: Electric
Range Type: Electric
Energy Path:
Sprinkled Building: n/a
3
Phone Number: 541-746-4545
Expiration Date
05/07/2007
08/14/2007
05/07/2007
Phone
541-689-7762
541-686-5444
541-689-7762
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
5,785
1,620
320
130
I DEVELOPMENT INFORMATION I
REQU:WED PAR"ING
. \,,\\J '~ . 2
Overlay Dist: \~otal:~\l
# Street Trees Rqd: I nO:- \'i- .Hli~dicapped:
o\'p~ ~'\\\' "y...
'Paved Drive Rqd: \ t~ ~~ Ctmpact:
% of Lot Coverage: <:" S\\\>-\j3.~\S ~\l~'::
..\t\'\\~~~~~ \\~'V~~ \>-'O\>-~
I PUBLIC 1MPROVEMF.)~:f~'~~~'V \):\.~\l\)'
'r-v ~~\:.\~ .-.1,
c,\l~\,\ <(1) '\Sidewalk Type:
\>-~'" Downspouts/Drains:
Pattiallv Improved
Yes
;,
Curb and Gutter
Notes: Storm Drainage to curb & gutter. Private curb & sidewalk per Ken. No permit fees for cubcut or sidewalk. However
Owner is required to provide sidewalk and/or repair as needed for driveway/storm drainage.
Paee 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
Bid Amount
Foundation Onlv
Garaee
ManufHome
Use Bid Amount
Use Bid Amount
Garaee
Manufactured Home
Fee Description
Plan Review Residential
+ 100/0 Administrative Fee
+ 8% State Surcharge
Addressing Assignment
Fire SF Fee - Residential
Garage/Carport
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder
Manufactured Home Placement
Manufactured Home Service
Plan Review Major - Planning
Plan Review Residential
Sanitary Sewer - 1st 50 Feet
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
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Storm Sewer Each Addtll 00'
Water Line - 1st 50 Feet
Willamalane Manuf Home Private
Total Amount Paid
.
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
$1.00
$1.00
$26.00
$1.00
Square Footage
or Bid Amount
3,380.00
7,000.00
320.00
50,000.00
Total Value of Project
Fpp< pqiIiLI
Amount Paid
$100.23
$73.51
$50.53
$31.00
$103.50
$177.60
$30.00
$45.00
$50.00
$160.00
$50.00
$198.00
$15.21
$45.00
$474.97
$624.64
$10.00
$961.52
$91.61
$145.31
$68.29
$836.32
$189.60
$1,083.37
$45.00
$14.00
$45.00
$1,000.00
$6,719.21
Date Paid
7/31/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
8/29/06
Paee 2 of 4
. CITY OF SPRIr'l\.:rt'lJ<.LD
Building/Combination Permit
PERMIT NO: cOM2006-00967
ISSUED: 08/29/2006
APPLIED: 07/3112006
EXPIRES: 02/28/2007
VALUE: $ 18,700.00
Value
Date Calculated
$3,380.00
$7,000.00
$8,320.00
$50,000.00
$68,700.00
08/28/2006
07/31/2006
07/31/2006
07/31/2006
Receipt Number
2200600000000001079
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
1200600000000001342
.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-00967
ISSUED: 08/29/2006
APPLIED: 07/31/2006
EXPIRES: 02/28/2007
VALUE: $ 18,700.00
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Plan Reviews I
Initial Review 08/01/2006 08/01/2006 APP LLH
Plannine Review 08/01/2006 08/18/2006 APP TAJ
Public Works Review 08/01/2006 08/04/2006 WI JLP
Public Works Review 08/09/2006 08/09/2006 APP JLP
Structural Review
08/01/2006
08/28/2006
APP DLM
Survey required because of
minimum side setbacks.
Waiting for internal information on
Sanitary Sewer & Subdivison
Development from Ken V.
Storm Drainage to curb & gutter.
Private curb & sidewalk per Ken.
No permit fees for cubcut or
sidewalk. However Owner is
required to provide sidewalk and/or
repair as needed for driveway/storm
drainage.
Standard M.H. w/ garage comments,
All additional comments are on the
submitted drawings.
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.
IRp~
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.
Framing Inspection: Prior to cover and after all rough io inspections have been approved.
Drywall: Prior to taping.
Manuf Home Set Up: When installation of all piers or staods 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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Water Line: Prior to filling trench aod including required testiog.
Sanitary Sewer Line: Prior to filling treoch and including required testing.
Storm Sewer Line: Prior to filling trench.
Manuf Home Plumbing: After home has been connected to water and sewer.
Paee 3 of 4
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-00967
ISSUED: 08/29/2006
APPLIED: 07/31/2006
EXPIRES: 02/28/2007
VALUE: $ 18,700.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
MH Electric: When blocking, setup and plumbing inspections have been approved and the home is cnnnected to
the panel.
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 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 ofthe 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,p ta e mi ar located at the front of the property, and the approved set of plans will remain on the site at all
times du n c ion
P"l ~ -CI Jo
.
Owner nr Contractors Signature
Date
Paee 4 of 4 '
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(S4I)726-3753 . FAX: (541)726-3689 ~:"~
ELECTRICAL Ptf:.RMIJ: APPUCATION :-..
City Job Number tlD I L\ \..0'1 Date 0 l7....q J 2rrn &;
1. ~~~p~~
LEGAL DESCRIPTION \
\ "\ D"O'L ~ \"\: b,,'bcx.:>
Installation, Alteration or Relocation
200 Amps or loss
20 I Amps to 400 Amps
40 I Amps to 600 Amps
Over 600 Amps or 1000 Volts see "B" above.
S' fS" EI " N D., iI1J~;.rifti'Ci~buits1:'~'~'1!~I~li\'ii!ili.Ciiii~:~'filli;~~;;.'~~~I.i(1.'\
19nature 0 upervlsmg ectnclan 0, tft"~-u=,,"-~ ...."t...-.~.,_......",w-~:i.~~~!!i:.'!;~~,~E~'l'- ~~~~
/'~ ---2--.- THlsNew,Altcration or Extension Per Panel
- /..., -. AUTlOn~7:!rib~it"HALL EXPIRE IF THE WORI($ 43,00
r")""Zr" I IMf1F;r' T' J/" n-
(' ... ..lCOM Each ~dditional GirC.:Uit or withlMIT IS NOT
Owners Name ~-\~l "it m~ii&e"0?~1Pd~Sp.e~iNDONED~CR.. $ 3,00
CAldtydr~ess -~~.J S'h~one- ~ ~" E. .~~i~~~~ill~.m~~,~!:!LI1LThYf~~~~m1t~~~~
\M \:'-J 'fo...-.) Pump or irrigation .' $ 50.00/
Sign/Outline Lighting $ SO,OO
OWNER INST ALIA nON Limited Energy/Residential $ 2S,OO
The instnllation js{.ing made on property I own which Limited Energy/Commercial $ 4S,OO
is not intendeMor sale. lease or rent. Minimum Electric Permit Inspection Fee Is $45.00 + Surcharges
i 4 ~'S;~;1~BT()1:4LOFA:Bo~~~~:f~:t;; '.'~~~~~. 10"" CO
Owners i ature: . ~:"~~:-s'u::~a;g-e"' ~ .~,t~:(orJ~,i_'~'~~2 . ~'. (XJ
/ 10% Administrative Fec \ f2.0()
Insp.ktlon Request: 726-3769 TOTAL 1\: B ,aJ
JOB DESCRIPTION
~-r~
Permits are non-tra crable and expire If work Is
not started within 180 days of issuance or If work Is
Suspended for 180 days.
raeo~aORr:OO~~Nirl
2. ff~It:~;';;;;L'it.'i<t'.D;.I!llWh'~IN"'>lU<;<j~.ltl!lls!li'll~li
Electrical Contractor A 65 ,E, ("c /, /c he.
Address ?tJ &J y d:(!' d /
City 6-1'!}e/'Je
Phone &7 ,f &7 -"J ,/1,/</
Supervisor License Number
y'7ytJ/S
Expiration Date
//) -/ 217
Constr, Contr, Number
/5C;0 7,.f
,1" -/5' -t:? 7
Expiration Date
3. 1~(jMPLETE FEE SCHEDTJT;?'.BELqJf~~lliFl~!~,;;j~~~iill
,:w;....,'_.~K.~..h.......~I'~"...,._,!>.y~..~~~~;):o"~ ~~~1ill.!:iti.amd:.~:f:ll
A. iNc~RJid~~ti~I~~$i~'gTh~~~Muld;F~~~~~d~lli~'g ~~~t~i:;~~~~
ti18la~~.....' --.. -"-'~lMI!l...;.u - -~~..~,ll1I',.~~WIf~~'-l- .;,,........~,....,.,.;
Service Included
1000 sq, ft. or less
Each additional 500 sq. ft, or
ponion thereof
$106,00
$ 19,00
Each Manuf"ct'd Home or
Modular Dwelling Service or ~ $SO.oo \ W_.riJ
Feeder
B. ~~hl&:1?r:;'c'e'~'~;~i~~~~Aii~1:itrot~Rcl~~
lie~~..~~~ii1'.:!i.i~'~I'''<~~:;Oh ~~~..:n;~.Jb~
. ", -I " .- regan Ut'"
_ 200 Amps or less, ,~c -= ([,!"'~ _. $'63,00
i, 1 ,,_, _ '-, 1 r U- . _d.... >:>tj[' -
20 I 'Amps to 400 Amps ',augh (\ ^ n _$)'15JOO
40}AinPs,to&OO'An~p~ Cap,as Of t"'~ v""-CS12S,OO
numb... f -"""f. (Note .- 'u/es"
601 A:n'ipS'to'IIQOQ;,A_mps : the 1/010_" $1'63,00
Over l6ij01A'inPS/V~I't's~n Utility Nnt;;;-:~':: le$37S.00
Reconnect Only- "uv -332-234.11 --"Ur$ 50,00
- ".,,, ", '-',....,"H;!" . ~~-' '~- '
C. ~Tc~po~a\i;,Sen'kes~ofFeeae~_~~, '::~ . ~t':{~,;_~~~4t. ,',:'.i!: '~:j
~.....~....~__._. ........_............. ._._. ~_...~,,~._,l.......~.. ~
$ SO,OO
$ 69,00
$100,00
Shurt:d Drivt:(T:)/Building Forms/Electrical Permit Application J -06.doc
CITY OF StltNGFIELD SYSTEMS DEVELOPME"ORKSHEET
JOURNAL OR JOB NUMBER: C0M2006-00967
NAME OR COMPANY: Jack & Sandra Gardner
LOCATION: 2601 MaiaLp.
TAX LOT NUMBER: 1703251407300
DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE
NEW DWELLING UNITS I BUILDING SIZE (SF: 2156 LOT SIZE (SF):
o
'1-"0
I~
10
U
10::
lu.l
,t->
00
-
o
~
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S.F, x 1 COST PER S.F, I CHARGE I
1 3228,00 1 $0.336 = 1 $1,083.37
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUS S.F, 1 x 1 COST PER S.F, I x I DISCOUNT RATE I I
.1 0,00 I 1 $0.336 1 50% = I
ITEM I TOTAL- STORM DRAINAGESDC '$t,083.37 l
2. SANITA.RY SFWER - CITY
DISCOUNT
$0,00
$1,083.37
1070
l
A. REIMBURSEMENT COST:
1 NUMBER OF DFU's I x
I 24
B. IMPROVEMENT COST:
I NUMBER240F DFU's I x
$19.79
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
COST PER DFU
$26,03
$624.64 1091
$474.97 1092
= ,
51,099.61
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRlP RATE I x 1 NUMBER OF UNITS I x I COST PER TRIP x 1 NEW TRIP F ACTORI
I 9.57 1 I I $19,81 1 1.00 1 5189.58 11093
B. IMPROVEMENT COST: I
1 ADT TRIP RATE 1 x I NUMBER OF UNITS I x 1 COST PER TRIP x INEW TRIP FACTORI
I 9,57 i I 1 1 87.39 1 1.00 I 5836.32 11094
ITEM 3 TOTAL - TRANSPORT A nON SDC = , 51,025.90 J
4. SANITARY SEWER - MWMr.
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
1 I I 591.61 = 591.61 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's 1 x ICOST PER FEU
I I 1 I $961.52 = 5961.52 , 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 11054
MWMC ADMINISTRATIVE FEE 510.00 11056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , 51,063.13
-
SUBTOTAL (ADD ITEMS I, 2, 3, & 4) =, $4,272.01
5 ADMINISTRATIVE FEE,
1 SUBTOTAL x 1 ADM, FEE RATE 1= I CHARGE
I 54.272,01 I 5% 5213.60
TOTAL SANITARY ADMINISTRATION FEE: 145.31 11079
TOTAL TRANSPORTATION ADMINISTRATION FEE: 568,29 il1078
Jeff Proeiw 8/1512006 TOTAL SDC CHARGES = I $4,485.61 I
PREPARED BY DATE I
. .
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTIJRES x UNIT EQUN ALENT - DRAINAGE FIX11JRE UNITS
(NOTE, FOR REMODELS, CALCULATE ONLY TIlE NET ADDmONAL FIXTIJRES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BA 11ITUB 2 0 3 = 6
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETe. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER / MOP SINK 1 0 3 = 3
CLOTHESW ASHER - 3 OR MORE rEA) 0 0 6 = 0
MOBILE HOME PARK TRAP P PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG / WATER STATION / ETC, 0 0 1 = 0
IRECEPTOR FOR COM. SINK / DISHWASHER / ETe. 1 0 3 = 3
ISHOWER, SINGLE STALL 0 0 2 = 0
ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCiAuRESIDENTIAL KITCHEN 1 0 3 = 3
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2
I SINK: SINGLE LAVATORY/RESIDENTlAL BAR 1 0 1 = 1
IURINAL. STALL / WALL 0 0 5 = 0
ITOILET. PUBLIC INSTALLATION 0 0 6 = 0
ITOILET. PRIVATE INST ALLA nON 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 24 ~
-EDD (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 Jt8.Ilons ocr day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I YEAR CREDIT RATE/$I,OOO IJ
ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 2
I - -
BEFORE 1979 $5,29 (Enter I for Yes, 2 for No)
I '979 $5.29 IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? 2
I 1980 $5.19 (Enter I for Yes, 2 for No)
Ii 1981 $5,12 BASE YEAR 1979
1982 $4,98
1983 $4,80 CREDIT FOR LAND (IF APPLICABLE)
I '984 $4,63 VALUE / 1000 CREDIT RATE
1985 $4.40 SO.OO x S5.29 ~ , SO.OO I
I '986 $4.07 II
I 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
I 1988 $3.22 VALUE/1000 CREDIT RATE
I 1989 $2,73 $0.00 x $5.29 0
I '990 $2,25 I
I '99' $1,80
I 1992 $1,59 TOTAL MWMC CREDIT = $0,00 I
I 1993 $1.45
I '994 $1,25
I 1995 $1.09
I '996 $0.92
I 1997 $0.72
1998 $0.48
'999 $0.28
2000 $0,09
2001 $0,05
225 li'ifth Street
'Sp~iJtgfie'ld;Oregon 97477
541-726-3759 Phone
.
~
WiL'd
<;Aof Springfield Official Receipt
_Iopment Services Department
Public Works Department
Job/Journal Number
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
COM2006-00967
Payments:
Type of Payment
Cred itCard
cRcccioll
RECEIPT #:
1200600000000001342
Date: 08/29/2006
Description
Addressing Assignment
Willamalane Manuf Home Private
Manufactured Home Feeder
Manufactured Home Service
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Sanitary/Stonn Admin
SDC Transpo Admin
Plan R~view Major - Planning
Plan Review Residential
Fire SF Fee - Residential
Garage/Carport
Manufactured Home Placement
Manuf Home State Issuance
Sanitary Sewer - 1 st 50 Feet
Water Line - 1st 50 Feet
Stonn Sewcr - 1st 50 Feet
Stonn Sewer Each AddU 100'
Manufactured Home Conn - Plmb
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
WILLIAM HARRISON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 095944 In Person
Payment Total:
Page I of I
II :07:36AM'
Amount Due
31.00
1,000,00
50,00
50,00
1,083,37
624.64
474.97
189,60
836.32
91.61
961.52
10,00
145,31
68,29
198,00
15,21
103,50
177.60
160,00
30,00
45,00
45,00
45,00
14,00
45,00
50.53
73,51
$6,618.98
Amount Paid
$6,618,98
$6,618.98
8/29/2006