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Home My WebLink AboutPermit Building 2003-8-5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~rK11~GFIELD ' Building/Combination Permit PERMIT NO: cOM2003-00615 ISSUED: 08/05/2003 APPLIED: 07/10/2003 EXPIRES: 02/05/2004 VALUE: $ 13,972.00 SITE ADDRESS: 2606 MAlA LP ASSESSOR'S PARCEL NO.: 1703251405400 Springfield TYPE OF WORK: Manufactured Home on Private Lot TYPE OF USE: New Residential PROJECT DESCRIPTION: M.H. setup w/ garage on single family lot- Owner: DOROTHA M RILEY Address: 1255 E PHILLIPS EMMETT ID Contractor License HARRISON JACOBSON INC 66447 RALPH W BROWN '1~W~ HARRISON JACOBSON INC o..u\~0S ~6.~ ('i. HARRISON JACOBSON INC _ ,~~ ~e f"\~0Q,oh6f[i4~~f\" I BmnDlN~lNFORMA.:NON L\~" \. V J I r.. I" ~\~ 0-00"" ~~u~ ~~~\. ~ \~..' 0(\0 ~-i~ ~u\0S tt\of'StoVes!O o\eS 0 \e\e9~ ~\01' lb~3)~ ~\o(\. C~~ig)}\g.~\SI;!\\cU'!e'\e I ~o\\'\cfs.oo UaJ.~\c.e: 9~'l-..olfy.pe"OfHeaf:':l'\\~l\rCed~lElect VN~~Q"'~ -{OU ~'X~!lr:~PJ~o(\ ~~7.:'t. Electric \\ 090. . (\~ \\Jt~'!,,~~tYll.e.'OQQ- Electric t3 c.'O\\~ e~Blier,~P;,lh: (lU"""-o 00(\. REQUIRED PARKING Total: 2 3 Handicapped: Y Compact: es % of Lot Coverage: 28.0Q.. 'lNQ~'f,. \y '\~"t. ~Q'\ .n,Q.t : ,,'1 \~ I PUBLIC IMrFVE~~m t.~~\~ \'~i\) yU" ~~\~ \'t.~~~~ \)~~\~ t>-~~alk Type: ~\~Q\'\ ~Ct.\) ~ t.~\Q\)DownspoutS/Drains: Sanitary and Storm Sewer is ~C~,\!~s-.~I:l \)~ \' t>-~'{ '\ Contractor Type General Electrical Manuf Home Inst Plumbing # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I CONTRACTu,," mrORMATION I I DEVELOPMENT INFORMATION I 15.00 5.00 40.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: 21.00 0.00 Paee I 00 Phone Number: 208365-7134 Expiration Date 05/07/2004 02/15/2004 05/07/2004 05/07/2004 Phone 541-689-7762 541-729-1500 541-689-7762 541-689-7762 Lot Size: 5,547 Sq Ft 1st Floor: 1,129 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 440 Sq Ft Other: Impervious Surface Area: . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00615 ISSUED: 08/05/2003 APPLIED: 07/10/2003 EXPIRES: 02/05/2004 VALUE: $ 13,972.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Foundation On1v Garaee Manuf Home Use Bid Amount Garaee Manufactured Home $ Per Sq Ft or multiplier $1.00 $23.80 $1.00 Square Footage or Bid Amount 3,500.00 440.00 45,000.00 Vallie Date Calculated Description Tvpe of Construction Total Value of Project $3,500.00 $10,472.00 $45,000.00 $58,972.00 07/10/2003 07/10/2003 07/15/2003 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $90.09 7/10/03 1200200000000001740 + 10% Administrative Fee $58.16 8/5/03 1200200000000001891 + 7%. State Surcharge $40.71 8/5/03 1200200000000001891 Add, Alter, Extend Circ Ea Add $3.00 8/5/03 1200200000000001891 Addressing Assignment $8.00 8/5/03 1200200000000001891 Annexed 1979 or Before $-148.45 8/5/03 1200200000000001891 Building Permit $138.60 8/5/03 1200200000000001891 Manuf Home State Issuance $30.00 8/5/03 1200200000000001891 Manufactured Home Connection $45.00 8/5/03 1200200000000001891 Manufactured Home Feeder $50.00 8/5/03 1200200000000001891 Manufactured Home Placement $160.00 8/5/03 1200200000000001891 Manufactured Home Service $50.00 8/5/03 1200200000000001891 Plan Review - Planning $59.00 8/5/03 1200200000000001891 Sanitary Sewer - 1st 50 Feet $45.00 8/5/03 1200200000000001891 Snnitary Sewer - Improvement $344.20 8/5/03 1200200000000001891 Sanitary Sewer - Reimbursement $452.80 8/5/03 1200200000000001891 SDC MWMC Administration $10.00 8/5/03 1200200000000001891 SDC MWMC Improvement $34.83 8/5/03 1200200000000001891 SDC MWMC Reimbursement $332.86 8/5/03 1200200000000001891 SDC Sanitary/Storm Admin $77.75 8/5/03 1200200000000001891 SDC Transpo Admin $49.05 8/5/03 1200200000000001891 SDC Transpo Improvement $727.42 8/5/03 1200200000000001891 SDC Transpo Reimbursement $164.89 8/5/03 1200200000000001891 Storm Drainage Impervious Area $617.41 8/5/03 1200200000000001891 Storm Sewer - 1st SO Feet $45.00 8/5/03 1200200000000001891 Water Line - 1st 50 Feet $45.00 8/5/03 1200200000000001891 Willamalane ManufHome Private $1,000.00 8/5/03 1200200000000001891 Total Amount Paid $4,530.32 I Plan Reviews I Initial Review 07/11/2003 07/1512003 APP LLH Paee 2 of3 'n='--- ~ . . CITY Uti ~rK.ll-luN~LU ~tatus Issued Building/Combination Permit PERMIT NO: cOM2003-00615 ISSUED: 08/05/2003 APPUED: 07/10/2003 EXPIRES: 02/05/2004 VALUE: $ 13,972.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plannin2 Review 0711512003 07/22/2003 APP AJD Public Works Review Structural Review 07/1512003 07/15/2003 07/16/2003 08/04/2003 APP APP MAS DLM Tara Jone contacted applicant 7-18-03 to request revised plot plan. Sanitary and Storm sewer is private. Standard form comments for M.H. with garage/carport. 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. L Reouir~d In~n~c~ 1 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. 2 Footing: After trenches are excavated. 3 Foundation: After forms are erected but prior to concrete placement. 4 Shear Wall Nailing: Before covering sheathing with finish materials. 5 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 6 Drywall: Prior to taping. 7 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. S Manuf Home Set Up: When installation of all piers or stands is complete. , 9 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. 10 Final Building: After all required inspections have been requested and approved and the building is complete. 11 UnderOoor Drain: Prior to cover or placement of concrete. 12 Water Line: Prior to filling trench and including required testing. 13 Sanitary Sewer Line: Prior tn filling trench and including required testing. 14 Storm Sewer Line: Prior to filling trench. IS Manuf Home Plumbing: After home has been connected to water and sewer. 16 Rough Electric: Prior to Cover 17 MH Electric: When'blocking, setup and plumbing inspections have been approved and the home is connected tn the panel. 18 MH Service: Approval required prior to utility company energizing service. 19 Final Electric: When all electrical 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 nt all times during construction. j} III \ ~t~ .P?-,<:;-o3 Owner or Contractnrs Signature Date Pa2e 3 of3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 COM2003-00615 C0M2003-00615 Payments: Type of Payment Check ~1 ~"~,~.. Receipt #: 1200200000000001891 Description Addressing Assignment Willama1ane ManufHome Private Manufactured Home Feeder Manufactured Home Service Add, Alter, Extend Circ Ea Add 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/Storm Admin SDC Transpo Admin Annexed 1979 or Before Plan Review - Planning Building Permit Manufactured Home Placement Manuf Home State Issuance Sanitary Sewer - 1st 50 Feet Water Line - 1st 50 Feet Storm Sewer - 1st 50 Feet Manufactured Home Connection + 7% State Surcharge + 10% Administrative Fee Paid By GOODEN HARRISON Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department i Public Works Department ' Date: 08/05/2003 9:37:30AM Amount Paid Item Total: 8,00 1,000,00 50,00 50.00 3.00 617.41 452,80 344,20 164,89 72 7.42 332.86 34.83 10,00 77,75 49,05 ( 148.45) 59.00 138.60 160,00 30,00 45.00 45.00 45.00 45,00 40,71 58,16 $4,440.23 . . How Received . In Person Payment Total: Amount Paid $4,440,23 $4,440.23 . 225FfFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 www.ci.springfield.or.us MANUFACTURED HOME SET-UP AGREEMENT . As required by the City of Springfield Development Code,1 understand and agree that with the approval of the attached permits, one of the following manufactured homes will be placed at ~{X., ~ .LjJ . .. , Springfield, Oregon, City Job Number (?~ "'.....,.., "l! -'-'0 c& IS;- L,....---'Type 1 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 of 3 feet in height for each 12 feet in width, that has no bare metal siding or 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 ~erformance standards required for single family dwellings at the time of construction.;;>\ U initials Type II Manufactured Home: A unit of not less than 12 feet in width enclosing a minimum floor area of 500 square feet, that has a . nominal roof pitch of 2 feet in height for each 12 feet in width, that has no bare metal siding or 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 for single family dwellings at the time of construction. initials 1 further state, by niy signature below, that I have been provided with the following information: . ,. Manufactured Home Blocking, Water Line Connection, Street Tree Standards, Sanitary Sewer Connection, Electrical Connection, and Minimum requirements for penn anent steps. I also understand that the manufactured home shall be placed on an excavated and backfilled foundation not to exceed 6 percent slope within 10 feet of the perimeter enclosure, enclosed at the perimeter with stone, brick or other concrete or masonry materials approved by the Building Official and with no more than 24 inches of the enclosing material exposed above grade. ~II/)~_. Signature 'f3 ..5 --03 Date fb.~ '\0' . .~0~;6~'V '" :,; 225 FIFTH STREET ',: ,\ ::-'~:\ ~-~ i'< .". '. __. CAL P}O,RN,lIT APPl.:1CATlqN . , r,C\'SPRINGFIELD, OREGON 97477 jt:'fri,,;t',~\0 ',." ., !'.; "'~':("..i ' "" ~ ..--, ,'" I ~' . . .$"'~ ~~ ~ \' j' - ,., ~~tJ:'tV:\.~',',f'V\"^~ (,-, ,'c, ~~ INSPECTION REQUEST: 726-3769 '\<'~io#,z.j\m" " Itd umher'f.. l~~ '~:' :-~~.:-~ ~:YOI:FICE~_ 726~3759:\\~~ ~:~ :'.fJ '(~~~~(\~;~ ~,:~;{j" tJ .;7.~:' ~:;,- ; {\, {~:-:~~,.._~, ._". .~'~::;:(: ;' .r..: i.;' 'k, ':'.," ~~~" ': ~,," :,~ t),ih- ~'f'0;;<,.~'.,.i~: r~",:\" ".CO' LETE FEE'SCHEDULE BELOW" >";"'"~-::':: ..e-,:,-::,;, " ~ , . ....~.,. 1'__'o<.\oQ-: ~1.-o~.~~W ~'~.:t:....~ '~.' '..~. ",J~...., ,"',' "':'..-'9 , r., ,f'y,r i:: 1. LOCATION OF INSTALLA1T~0~ '." t\."1l'" '9 t:~,,0:. 1,,,,,,', b":'~; ,;1::~,~.,.".f!: , ',';', '''~:~':'''''\: ,;', . ~.~ ~ '\'0 "C"'lr."\.'+ .~~ lctor,.. "'.'~'V""'.J"-(">'~.'" i"< "'R'~'f"~"" "~'-~ '" . . f) '! l' n u ,t"'t ,JY , . ....~~i:I" ",:'Ne,,: Residential-Single or"',"'""""'" ' ;, .'C'",," "".' '-, Q0' 0"..00 Multi-Family pel' dwelling unit. LEGA....J1E~SRIPTION <==A ,...,........'rsS' Ser"icc Included: \rtl)'~\~ O~ Items Cost. . ,- ~ . ,..",". " , .~i;;: JOB DESCRIPTION . 1000 sq.ft. or less $106,00 ,c,-_., ~ .N\r. (\,~n '\:s \Q~e.. ;~'c~ ~~~~~i:~ 500t,:.',',..;..~ Permits ~rc lion-tr~nsfcrable ~nd expire thereoF $ 19,00 _ . " if work is not'st~ned within 180 d~"s E~ch M~nufd HOllie or " . ',' . 'c' ~~g~,,~~,~ce ?;ifWOrk is suspended'for ~~~~:~~r~;~~:~ ii:::'. .~ $ 50,00 rc!b.u) .":.' :. .' :. .-~::..".>'~'" ,", ..' ~'(~. ." 2 CONT~2rORINSTALLAT[ONONLY B. Ser"i&~~rJe.eders .' ':;-:i:;Cd '\;:.;'c.J;..,. ",('"-,: .".,.. ,.~';' ~ '0"'~I".~"li"tlOn, Alterahons,o~, "':, ,",;,"." \,.'.- \ _"' .... .\.\' €\,"V \0: ... '''''''', '''- .,,?, . ~. Electrical Contractor.: ~ r>: ,v ,,-O'.KC!!fCn.tiOIl. :li~~,:;:;%r~r"'I\:,...~;~<t~ i.}\. ,~;;.,. " . ,\v 0'=' "::> l';';; .'.f-' .~~, .......-1'.' ~<.. , "r o..! ", . ,::'-'c,' ""'~ ~'-ll O~ ~0 ",r \ ....,J.~..1<..,..'. }",J!C':'" ""'~" ,'., ~'.yA{f-,:'~/~-'". At.~ 0 ~ n,.".) ~ ..,..-<(......:,.o;.'~~A~_'I._I:>l\.'.':r-.:.'f.ls.. '-~;.."~ :<:f. Addless /U,T .....,:.~:,?~~ ;)" ,-a~ ,~0'" :Wtl"lu\<#,ore,esi'.' ',::''::'~S':;-:..:;(;'.': ,~~.~$..63~QO, ,::i'?: ", i ." ~"~"" "" ~>6~$ 'O'"'''"~v Or '" ~<^ '.," ,-_..~" ..,-,< -' ,... ~~'1, ;:\ 1 ih,l'';'' i ::;I:'~f 'lI!:(jj~, '/''' t"~ - ;..~~~^~ 20~'\{lmp.?-'t\'):leP amps"~':;~"'{.--A:< 1~" '., <,':'> "$~7.).OO " J-:;: "~-l-"''';' . "~.I)~_~"\ J _h .v,'"l~'\" Ci'\..\~~ t:\'1'!j. ,....~~;-.~"'rrIJ,'~... \,~'t;,'''';'''''----:-;:;-J "ll'{:;';, City '~,.-. 'rhone~,~ . 'l.,i; ':';::J ''&l~.'i'0'" 4~\.<9m~t'7.{)00 ~111pS, ')::;,,"'-;'.-:;';. '.'-. :',':,,$1,2.),O~ ):r~,,,; J ~C", Q" 4 "i -'c" 0'J;;&?,,~, ?\~~~'~o<f>.';",\GOl ~ljl)is to 1000'amps ,~, "~:',,: '. <", ":$163.00 ',,~,",. ;~~!:~ Supen'is9/~i~~i;se~l~;nbe~"\f(:1~f\U ,;,,~~,__;.~~~'b'-~~~~r ~ u6Q~?~p~i.ol~ ~;::5~J)~:~:~,. .,~, ~b:$~,75.00" .. ,~~-~ ,-,Lo"" , .,.' ,..""" .~'" .' ~,v", "r~' ,,'Q.."9.,. ~",., >o:)'R'.c'J" . '0 1 " ,-, '.. ","" ," -' '$ "50' 00 ',. ~ ,.~,'j';b '" ,.:r- {"i~'~l)"""''''!);;1'~'''\.O~'1l ~';;"'r~,. >.,; ~~<;li(!-\,)( ,.h~~,. ~nnect, n y,,<(,,,:t,~c:;j3::;t,""".t....-~ ~,. -' .~._! ~...~,...,.. , . ' ,', ""'fOp~'" 0. lh'"$!)~ ~ ~ ....~ - il"\.V<>~O -: 10( ,,~'~ -'11' ~ ""~'~-;;..-"''', r, ~-, ~(' " -~" ',-.,.. ,~~~,tt~ EXpIratIOn,Date '., '-,'I:, . .~~ ,li:h<,:\'!Z J .- if:!\~~~~\' ~l';'\:'Y~''.~1:?~~~\J";;./1",,,'~~N~~1i$:;J'-i'\-4::rr~!~,~1,''''' ~'-t:;',:~~!,.ii~';t~~ 1;\j"" M4~ ~"'.~,'J;;;{"\I';;,~( .,.", ~_.~t:~., v-.' If ~C''I'~n:.T~~j.''; :'S"~'':'''' '~'F': '(rf-:"'l-Y.l:}'(~-"~'lJ ~,;.~~/,".,.S\:r"'~" }"';...., rS.,~ ~.......''''~' 'I"~",,-,, ~~ ;-,'''\1 :_'~ "."" .;..~~. cmpOlaJ) cr\lcesor., ee els<'~',,~~.,~ ,~'~_,;t,t~~~,- ~~~.:'~~ '~Const;:<;:o'nfr, Nuinb~~~;1;'~ '~t/r _ ~. ~~ ~... . ~~.~~~~(r;;t!lilaiio~;'~lt~'ati6~I'lftJ{el~~-ition\~t~~' .:>: j,:~~;~: :' ~~~f ....!:....,"" , ' _!...:..... '1:.;."1'i~! .,' ~'-" .. - _ .\.1-.- .. '~\:nr5 ~,!:; 'f ;::'v__v' ;-::-,. -.: ,-. t. '. ,.: ~;--;' .~. ':i~':'\-l:r-,.......I. ~ --.: ~.'" ,\ ,1:1"d,M"'f~.: ",{"l..7.:Io' j~<:,:.p/'-.,~ ---~4~'''' ,.....~t'\-... _.%'. ~,\\ ~~""O}u-.{.~-7<<,.~ ......,'t:~\~.~r..- , ;:~<' <')'1' ':'i.-vGt'Y;.:~~ .-~_~);,,''''':.r~_,.J"''_y'~'~~''J ,: <f:0.: ?;\ .' .....-#O.;:~~~.t ~"M'\' -ii~'/-' -~ :'>.3{~I+f~~- ,~~-h~:':'0 ',. ,,'-:"-:~' -,,'-:,:"'- Y '':;',\:'{:'1~-, ,)... ,',""I~J' ~-. ~"'''. 'Il:>~i$., :~~ :'];:v.r~::;.ExplfatlOn D:lte "~.' ~~~_' -' ~;t',;~~,~;.t;,~)~ :'(200 amps or less \T~!:; <:i:;f1~ n /:.-.~J' ..-~.'" ~'{'$)O.OO' ,~ r~"O~ ~, J,' ""~~ " , I -,., .""1~',,,,~\..: ,'I" ~ ".' ..-.' ,~ ,~, ,., '..)'~' _l"'':<';f'f..~; ~-"'..... .. - ~ .~..... ".:j...., J,~':, :. ~'..c....;:\",!.~-'.\!o.'-;t:~ :-~~"~'~"-"201 alhps to 400 anlps,,,J,~~";...l:<'~~J,,," .' ";':""'$6900' ~J>"..-, f~\"~"'~l~;'l:':':"" . .. .. ''-;1,e;.;~~,~;j.~~; .~_ . ':,' ."a;J"c'h ~'1~,;:,,!:,.4'''-~1:;''~1.,.->J ":1., ,~")..."~ ,~~.::;-!' .t':: SJlTnaturc of Supcn'lslIPT ElectncIan ....j .....~;z,O\'er 401 to 600 amps. (. }'::.~'>.. <:'. \~): ~.$lOO.OO ...~ J~' ',' "..';"'5:.,.'1 o~. ,...., b . . -' , ~' "''-\' '\!?\L.... . '... .~ - .. ;"''''~',..' i ' ,..c.~"., ,,"'.. O\'er 600 mnps or !(iO~~O see'''''''';'; ftO "y' '"".'j ~.,~...... l, 'T"~ ~.' _ ( 't "'~_i"\~ \'t.,. ..1 ':':-;.',," .', '~,".'" ,/;.' ');A cJ ~ "8" ~bO\'e -<VI '. ""'~(f\\"( " ;ii' ".,"' ;~" ;>, .,:,,,,,-;- , '.. ,,"~' .~, '..'" \_ < J' ..... \'t \ \c.. ,....v.. '",:: :'t;(~~-: '.,. ,.;.., -0;1 ""~'~li,..,:..--'';{:,'' '" :' . 11: o\~\.. ..t.\\'~ : '{'_.t.-l:;~<A"'!';;' (.:-"~;: ~~","X,_:, '/':' "'\' '< -Io:.i.\ otO\,,-\~' to'\\"- ",,,,~,,':;""','" ,:.' ,.',,';p',,;\y' ,.". k.t:.'dj.,;'~'/''''''-1~ Jl,. Bran\!'t-Qu.'t,ilJ.,\S'\" x.~'v """}'';;''~-i.f,t.',1 <u., k~~~(;,~' 'O;V1.ICI's,r{a~e~ n';\~~~ ~\C"(;'a.~\\ NC\,t1\!~;.);li'o~~~'\1lension Per p~~l :::.'::,~"';'~;; :;~}:: ,o!:j-.:,;::~.<\..~, " ,'. ,", ,"', .' ;'.-.;:., , '-~. ~..::",\ _ ~C;;\l"'" ",'U '0~ \'O~,?I" r;, ," ,- .'.0.';",";....... ~:;'" ;'~:~~~.'.;<:;:Add~es;.\'l.SS\'-:~('l::h. '..., .. .~ \\()\,,-\t ~l@~,~~i;): {.r"; :_'.~~jOO\;: . >~:: ,."if'" ;.,' ..;; ,','o',., '..\'., ";, \>,'0\ ~",~r:., ~'?"'~""" , C .'1\ ",' '. C'" . .'. .::\{;.'iCii),f:iT\~~Tf'>YhO~~ . " \~ \'O'\} ~Cil Addi;ional Circuit or with scn'ici:}'~~';'-~'5"bo.'."" 'J: :',:,"" ":', O\~NER iNS'T=:~: \'.~ or Feede~rermit".', ~'$ 3,00. .;, 'The installation is being madc 'q~'.. E. l\lisccllancou's (Scr'\'i~e/fcedel' not included) . .. " "; , 'property I o\m which ii'not intended .Each installation, .. ' - , for sale. lease or rent:' . ; ,., Pump 'or irrigation .... Sign/Ontlinc Lighting Limited Energy/Res Limited Energy/Comm ~j~ . -:' .t~~~,: " -_"__,J._ , ~:~:;:; " ~i,'~''''" ':'~~~~ "';..c. Su;;;<' ~~~r~' . . Owners Signature:, $50,00 $50,00 $25,00 $-15,00 I\-linimuTll Electric Permit Inspcction Fcc i~ $45.00 + Surchargc~ ,", " ,;."" TOTAL \ ()~.OO 1,'Ll \D~ J'l.D.5 \ , ",', , .n 4. SUBTOTAL OF ABOVE 70/0 State Surchargc 10J% Administrati"e Fcc >-.". ~'. . . . , CITY OF S!NGFIELD SYSTEMS DEVELOPMEN_ORKSHEET JOURNAL OR JOB NUMBER: Com2003-006l6 NAME OR COMPANY: Dorotha M, Rilcv LOCATION: 2606 Mai. Loop TAX LOT NUMBER: 17032514 t15400 DEVELOPMENT TYPE: SINGLE F AMlL Y RESIDENCE NEW DWELLING UNITS I BUILDING SIZE (SF' 0 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 2129,00 I $0,290 = I $617.41 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 $0,290 I 50% I = I $0,00 ITEM 1 TOTAL - STORM DRAINAGE SDC $617.41 , 2. SANITARY SEWER - CITY r- Iel) I~ 10 I~ 5547 I ~ eI) - c:J ~ $617.41 11070 . . ,. . . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE [="~, NUMBER OF NEW AXTURES x UNIT EQUIVALENT - DRAINAGE AXTURE UNITS (NOTE, FOR REMODELS. CALCVLA TE ONLY THE NET ADDITIONAL RXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE NEW OLD EQUIVALENT UNITS ~ -- BATHTUB 2 0 3 = 6 IDRlNKlNG FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL 1 SOLIDS / ETe. 0 0 3 = 0 IINTERCEPTORS FOR SAND 1 AUTO WASH 1 ETC, 0 0 6 = 0 !LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER 1 MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I !RECEPTOR FOR REFRlG IWATER STATION 1 ETe. 0 0 1 = 0 I IRECEPTOR FOR COM, SINK 1 DISHWASHER 1 ETC. 0 0 3 = 0 I ISHOWER, SINGLE STALL 0 0 2 = 0 I ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I ISINK: COMMERCiAURESIDENTlAL KITCHEN 1 0 3 = 3 I SINK: COMMERCIAL BAR 0 0 2 = 0 i' ISINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LA V ATORYIRESIDENTIAL BAR 2 0 1 = 2 IURINAL, STALL 1 WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 I ITOILET. PRIVATE INSTALLATION 2 0 3 = 6 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 20 .EDU (Equivalent Dwelling Unit) is a discharge equivalent to ::inll;le family dwellin~ unit (20 DFU's) set at 167 ~lIons per day I MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I,OOO ANNEXED ASSESSED V AWE BEFORE 1979 54.92 I 1979 54.92 I 1980 54,83 1981 $4.77 1982 54,64 1983 54.47 1984 $4.30 1985 54,09 1986 S3.78 19S7 $3.41 1988 S2.98 1989 S2.52 1990 $2,06 1991 $1.64 1992 $1.45 1993 $1.31 1994 $1.13 1995 $0,97 1996 $0,82 1997 $0,63 1998 $0.41 1999 $0,22 2000 $0,04 I!:,- 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 o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE 1 1000 CREDIT RATE $30,17 x $4,92 ~ , $148.45 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) V AWE 11000 CREDIT RATE $0,00 x $4,92 0 TOTAL MWMC CREDIT $148.45 =