HomeMy WebLinkAboutPermit Building 1995-1-3
OWNER:'\. ~\1f)\_~ (', _" PHONE:~'{~n~-
ADDRccc" \\1-\() \ _ & \l ~ '\\: en n.
CITY' y ~M ) . . ~\ STATE: l~iQ "Arm
~H\~n(10 ill r\r\\\(\m~ 'J
NAME ADDRESS
ARCHITECTMoR.Q.JS Q~t..J. A-<<oLJ,,,,,, t" I UI2~-I-
.. CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAL:C~IMbcs?vt..~ ~.s4. 229S- tbblAl'tf' /4L .<::.:f,..,
PLUMBING' 7lJ): It,) \~\\)\) e,,,
MECHANICAL' ~f\'ct\.\.t'Nt> ~
ELECTRICAL\ _~ ~ l ~f\'d (\ <::.. F \ 0 ~
I PLUMBING I
I NO p'r I FEE I CHARGF
I $ Single Flxlure ~W/t /.0:9.- ~~-
I Relocated Bldg. I I
(new fix. addU)
I Water Service ft. I I
I Sanitary Sewer ft. I I
I Storm Sewer I
fl.
I Backflow Device I .
I ~7>'~A-r /9Kn..j,y~,/~:t..7
I ~''''''/r~ ~ &!wZ>~&-"...../
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'COM M ERCIALlI N DUSTRIAL
PERMIT APPLICATION
;
i
DESCRIPTION OF WORK:
NE~ *- REMODEL
ADDITION
DEMOLISH
,
TOTAL PERMIT
I
1
I
I
I~,-I
OUAD AREA: \ "IS\)lL)
. OF BLDG~'
OCCY GRoup:J~2
. OF STORIES:.L-J. JSJ!""~2'2.
I
I;
I::z.
1"1
J3
<1
/'2-
ZIP:
qr4.(')~
---
OTHER
VALUE:
PHONE
.EXPIRES
100
PHONE
h'i'7-7I'l.r
MECHANICAL
II:~J: "'~.o.~n1=
Furnace/burner & vent /. ...". /.'''>_~
<100.000 BTUs b ....
Furnace/burner & vent 7. """', . /.-.., pI'
> 100.000 BTUs --- p';'
t;~.-L~~~ ~. - :z. y_-'
Suspended wall or floor t -' , ~ J&>, -.:.
mounted unit heater c.c.- -/~..
Appliance Vent t
separate
Stationary evap. I I
cooler
Vent Fan/Single I ~~ t>bl
duct ~, I .:?::::a
Vent System apart I I .' I
tram AC or htg.
I. Mechanical exhaust t I I
hood and duct
I~?~~;>;;::, I.S'PI ~,.-;I
t $10.00 I
t/~.4
TOTAL PERMIT
Permit Issuance
SO. FT. $/ SO. FT.
.SO.FTG.MAIN ~-~.... x 'm
. ' ~ VcP' VU" ;;, l!?i' C'",....~~
. SO. FTG ACCESS ~t!?'22 ~79<t:.. X m
SO. FTG OTHER ?~~E7if'~~. X ~ m
i::71Ef:>/7 ~ r ~?9//'--;'--r">~ r""~
I~ep Q?l4'C:-?{ . .
~~c~J:l1;~'~/J;CJ?~~' DATE
- OF~~-
LAND USE: ~ ~y q
# OF UNITS:
CONSTR. TYPE: S~_ ~
r ,
HEAT SOURCE:~" ,..C((~o-.
HANDICAP ACCESS:
FLOOD PLAIN'
<':::'L".
ZONING' '-.:l '. \
LIGHTING POWER BUDGET:
WATER HEATER:
VALUE
1;2.."2 2. .~~~
,
'.
'CUt~)
J/4(i)1ro~ .
. I
l \..?fA ~ BY ~f\W
?~ . -(.;>
/~~
TOTAL VALUE OF .PROJECT
I BUILDING PERMIT I "::? <{ /~ """'" I PLUMBING ~,-c:> 'DEMOLITION I. . _.. _I
15% State 1 ( )~. ~~ 15% State r-5' "?- -17 ...oIf'............... /"CI#-f" 1t-......."..'Y'/2'- u_ 'f-'
Surcharoe , "7 L> Surcharoe .,... ~ ~. O/~ e>~~ "....._.-.-.,.- "173.55' I
I MECHANlCAL I 7? . ~. -_- t FENCE t t 1
~P1.A/7 . I ~ ~ _ VALU~ $
15%State I-~~- fE>'~ ISIDEWA~ L" tSUBTOTAc I. I
Surcharae ,r-5~'..' .::f.9<::- ~"t"7 FT. <?I.~7'_.. 'PERMITS" I ~'1'''Y.N
I PAVING 'I ~7. - I C~~~"gTI FT. "Zi?>. --- I ~ml~~MENT I 17, :tS7. e>C;; I
d~RP7~Y~lJJ/'4-- ~ c::"/S ~p<':!ij!~..p
. . . . .. . ;OTA:l:PERM~T FEES I
.... EXCLUDING ELECTRICAl
I .":,f f4;J I ' ay
:<'0 7$€>, Idl
.
;.
REQUIRED INSPECTIONS
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It Is the responsibility of the permit holder to see that all Inspections are made at the proper Ume. To request an Inspection, call
726.3769 (recorder), state your City designated job number, job address, type of Inspection requested and when you will be ready
for Inspection. Requests received before 7:00 a.m. will be made the same workIng day, requests made after 7:00 a.m. will be made
the following work day. .
SITE INSPECTION: To be K ROUGH PLUMBING, )( PAVING: After gravel Is In
made after excavation, but ELECTRICAL & place but prior to placing
prior to setup of forms. MECHANICAL: No work Is to asphalt or concrete.
be covered until these
inspections have been made
and approved.
UNDERSLAB PLUMBING,
. ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel In place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all Inslab building
service equipment, conduit,
plplng,.accessorles and other
ancillary equipment Items are
In place but before any
concrete Is placed:
UNDERGROUND: Plumbing,
electrIcal, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to Installation of
floor Insulation, deckIng or
floor sheathing.
POST & BEAM: To be made
prior io InstallaUon of floor
Insulation', decking or floor
sheathing.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
MASONRY: Steel 10caUon,
bond beams grouting or
verticals In accordance with
UBC 2415.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
ATTIC DRAFT STOPS & '
CURTAIN WALLS
)l'
FIREPLACE: Prior to placing
facing materials and before
framing InspecUon.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are In
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special Inspector shall be employed
by the Ownerl Contractor durIng
construction of the following work. A
copy of the special tesUng reports shall
be furnished to the Building Division.
STRUCTURAL CONCRETE: In
excess of 2500 P.S.1. (306 a.l)
A
STRUCTURAL WELDS:
Performed on the job. (2722 f)
x
INSULATION & VAPOR
BARRIER: To be made after all
Insulation and required vapor
barriers are In place but
before any lath or gypsum
board Interior wall covering Is
applied,
FIRE & SEPARATION WALL:
Located and co.nstructed
according to plans.
X . LATH AND/OR GYPSUM .
BOARD: To be made after all
lathing and gypsum board,
Interior and exterior, Is In
place but before any
plastering Is applied or before
gYi>sum board joints and
fasteners are taped and
finished.
/
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete arJ.d form
work and sub.base material in ~ . .
place.
",..
HIGH STRENGTH BOLTING:
During all bolt Installation and
tightening operations. (306
a.6)
"Y
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
SPRAYED ON
FIREPROOFING: U.B.G.
Standards 43.8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.ll &
Chapter 29)
'GLU.LAM BEAMS: Inspection
Certificate by an approved .
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.G.
STDS. 25.10,11).
STRUCTURAL MASONRY: (306
a.7)
. t .. In additIon to the Inspec.
tlons specified, the Building
Official may make or require
other Inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
x.
FINAL PLUMBING
-------------------------------------------------------\
A'
~
FINAL ELECTRICAL
x
FINAL MECHANICAL
x
FINAL FIRE DEPARTMENT
~D(j~orE(~J3.DQ:\ ~ (i:O_
! ~T ..li \ Ism. \J'
SITE PLAN REVIEW BOARD: Must be requested 2 days In advance
of the date you wish InspecUon. All project conditions such as
landscaping, parkIng lot stripIng, etc. must be completed before
requesting this Inspection,
A
FINAL BUILDING: Request~d after the final plumbing, electrical,
mechanical and Fire Department Inspections are made and
."" .approved. No occupancy of the': premises can be made until a
. , CerUflcate of Occupancy has been Issued by the Building Division
.....and posted on the premises.
,...;.
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P.LANS REVIEWED BY
~ . . /'
r-
~~ ~;l~/ciATEnYC:::-9Y
--r . , I r .
By signature, I state and agre~; that I have care.fully examIned the completed application and do hereby certify th?t all Information
hereIn 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 descrlbea herein, arid that'NO OCCUPANCY
will be made of any structure without permission of the Bul!dlng Safety Division. I further certify that only contractors and employees
who are In compliance with ORS 701.055 will be used on this project. . "
....' - .
r(ur.th~r' ~gre~.!o ensure.~h'ata" r~qu.l.red.inspe~tlons are requeste~~t. the proper time, thai.pr~Oje~t address Is readable from the
street, that th.e permit card'ls located a't the front 6f the pr~perty, and .the approved set o'f 'plans will remain on the site at all
:::.:t:~~\):rDIOp ~ D' 6 . ~ " '. > D:t~ ~~.~? s
~ y.4'1
_ AMOUNT RECEIVED: ("~. -, ~oe:> ~bc' DATE'PAID'
, ,. .' . /? 2S7 yo- ,
. .. '. flECEIPT': _7."" "t"~ t:-
VALIDATION:
.' /.:.. ~~s;-
RECEIVED BY' rZ.---
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:
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.
SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
l:~ON~~rlO
\ r')~~~~IO~\\ \ l'p
JOB DES~~ _ _
e::;At4c~ .~'l'~
Permits are non-transferable and expire
if vork is not started vi thin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contract~ ~(\ ~
Address~i\~Q ('O&~
Ci ty f 1.') QJlJ'o. Phone"2:A ~.l t. 91
Supervisor L~cense Number ~~
\n. \.qs
Constr Contr, Number r-\~::>
PJ.S.C\5-
Expiration Date
I
Expiration Date
Signature of Supervising Electrician
~dL~
OV~Name ?t-/Y #~~
Address. /~ ;39~.&?~ ~.
Ci ty ....z:;.--.5I~~.Phone ~$.'!>-_';if1 Y'33J
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Owners Signature:
---------------------------------------
DATE: /.~'39
RECEIPT #: _ f_ '5. "? q
RECEIVED BY: ..e~
ELECTRICAL PERMIT APPLICATION
City Job Number Q41loW
3.
COMPLETE FEE SCHEDULE BELOV
A.
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
~
Sum
It ems Cos t
1000 sq,ft. or less
Each additional 500
sq, ft or portion
thereof
Each Manuf'd Home or
Modular. 'Dvelling
Service or Feeder
$ 85.00
$ 15.00
$ 40,00
B.
Services or Feeders
Installation, Alterations
or Relocation:
~
~
~e
/0l0.~
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
-~.~
200 amps or less
201 amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
I
C.
Temporary Services or-Feeders
Installation, Alteration or .Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see "B" above
D.
Branch Circuits
"
Nev, Alteration or Extension Per Panel
E.
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permi t ~ $ 2,00 ~~
not included)
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting.
Limited Energy/Res
Limited Energy/Comm
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
$ 40,00
$ 40,00
$ 20.00
$ 36.00 ~~
'. 92-?J ,tW
" 4L- 60D
-?7~
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ATIACHMENT B2
-JOB NO. 94/(;,20
.
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INDUSTRIAL)
NAME OR COMPANY: ~ 9b~
l.OCATION: ":J5"o ~
DE~ELOPMENT TYPE: ~ I~
BUILDING SIZE: LOT SIZE
C:;Q. Ft.
.
1. STORM ORAINAGF RooF'S t>~A/,ys GO To /),{'I WE~t. 5 - /YO SLJc. C,l/A.e6-J!"-
. .
IMPERVIOUS SQ. FT. x 0.5 x . 53 'j~O X $0,209 PER SQ. FT e~40 '{!)
f'ARKJI'/&Acr:1'Jgso S/W,P""TIOS' 9C.JO - so,,,,, (IN,(,6-IIT.rW04Y)
2. SANTTARY SFWFR.rTTY = 4~3D_
NO. OF PFU'S x 0.5 X
(See Reverse)
3. TRANSPORTATION
C.o
X $43,26 PER.PFU
'fI'1.fr.~O) ~
NO OF UNITS X TRIP RATE X COST PER TRIP
~DE /40 IVIANU.F4CTuJU/y(,. ~../""
0.5 X :3'6.~24 X (J.tS' X $436.19 fAaKIc.Ar/01(1S,,,.eME 11:3/1.~ 'f).~
CoDIt 110 (,E/'I, OPFIC"'(( f j.CPT ~T.Ir04G-~) r- . ~ _.~...,_~ ~~
0.5 X 1-.%0 X .2..:21 X $436,19 s(-Z-:~2TT<~~
0.5 X X X $436.19 . $~'Ja'f'.Y::<.fii?~
4. SANTTARY SFWFR.MWMf
NO. OF PFU'S (PO x $17.19 PER PFU + $10 MWMC ADMIN. FEE $ /" 41.10
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ d
1
TOTAl -MWMr. snr ~ 41. +::- ')
SUBTOTAL (ADD ITEMS 1.2,3 & 4) $ If., 12(.01
5. . AnMTNTSTRATTVF FFFS
BASE C~GE (SUBTOTAL ~ X .05
d~~,
/Mary Hbrn~g, P.E,V
SDC eOOrdlnator
$~
B2,SDC
Date: 1.2 - /3- 71'
~ -IQIAl snr, $ / 7, S.Y 7.0'
"/o/~ ?~p /c;..~-
Mc/?#CCP/~ ~;5'57.0.b
FIXTURE UNIT CALCUlATION TABLE: Numbcr of Ncw Fie;S X Unit Equivalcnt = Fixture ~'niis
(NOTE: For remodcls, calculatc on.e Mf.I additional fixturesl
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub......................................................................
Drinking Fountain...........................................:.........
Floor Drain.......................................... ..... .... .............
Interceptors For Greasc/OiI/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher ...... ..... .......,...... '" ..,....
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc.........
Receptor For Commerc;:ial Sink/Dishwasher/Etc..
Shower, Single Stall.................................................
Shower, Gang.,..'..."..... ...... .... ............ ..... .... .... '" ..,..
Sink: Bar, Commercial, Residential Kitchen.........................
Urinal, StallN~all.......,...........,.......,...............,.....,.....,
Wash Basin/Lavatory, Single....................................
Toilet, Public Installation........................................
Toilet, Private.......................................................
Miscellaneous: UANI rd p', (,,>IX:
f?RAf"JL/!.V )/AH,O wAs/!
2
1
2
3
6
2
6
6
1
3
~ 2 4
1/Head
~ 3 2 Co
3 2 cD
U '7 1 .1
6
8- 4 ~2
1 z 2
I J 3
TOTAL FIXTURE UNITS = (,,0
CREDIT CALCULATION TABLE: Based on assessed value. If im;:>rovements occurred after annexation date in table.
calculate credits separates.
I'
,
I.
I!
,I
I
I!
I
,
,
~ ear
.,
$3.45
3.33
3.32
3.21
3.06
2.92
2.73
1585
1986
1987
1933
1989
1990
1991
1993
$2.1.5
2.14
1.77
1.37
0.97
0.61
0.44
0.15
f
,
I
I
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f973 or befo:e
i980
1981
1982
1983
1984
1925
Ra~e ;:Jer $ i ,000
Assessed Value
. Year
Annexed
Rate per $ 1,000
. :c..ssessed Value
Annexed
Credit for Parcel or Land Only If Applicable
X $ =
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
Improvement (if after annexation date)
CREDIT TOTAL
[JEL.Ay/.'?D
A ,IV/'! e ,r A-r/ON
=$ /\/
/A
,
..
..
Ci4;y c~' S:,::f':l. i\S-;":'..E':: 1;,
225 ~~~~~1 Stl"l~et
\.,.
.......... .
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S8-':r~g;ie:d, G~ 97477
'7! '8.r'.s::.~;::T, ::. ~')!~ r;'Jnlb(:,~r' 0 S.583'5
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\:;oIYl."'.;;ci;/O'''\'>n ~
[;3, i33S
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CASCADE FA3R!CATION
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Thank you~ Lor-ne
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SYSTEH DEVELOPHENT CHARGE .
AGREEMENT FOR DEFERRAL
Pal-ties:
City of Springfield
flJN )J2,J T T9NI.
PAF.RIC.A rICIN
Development Applicant _
Oevelooment Proiect: ~~;{~t:
,
(SEE ALSO EXHIBIT A)
REC ITALS:
WHEREAS, the City of Springfield, pursuant to Oregon Revised Statutes
.223.297, et seq., "System Development Charges," has ~nacted an Ordinance,
Sections 2-11-1, et seq., "System Development Charges," of the Springfield
Municipal Code; and
WHEREAS, the purpose of the System Development Charge is to impose an
equitable share of the public cost of capital improvements upon the activity
of development that creates the need for or increases the demands on such
capital improvements; and
WHEREAS, Section 2-11-7(1) of the Springfield Municipal Code provides
for the payment of a System Development Charge at the time of the issuance of
a building permit, approval of development application for development not
requiring the issuance of a building permit, or a permit to connect to water,
sanitary sewer, or storm sewer systems; and
WHEREAS, Section 2-11-7(3) of the ~pringfield Municipal Code provides
that the City Manager or the Manager's designee may require payment in full or
that provision for payment satisfactory to the City has been made; and
WHEREAS, Section 2-11-7(4) of the Springfield Municipal Code provides
that any provision for payment satisfactory to the City which includes
providing an obligation to pay the unpaid System Development Charge and
interest thereon, shall be secured by property, bond, deposits, letter of
credit, deferred payment agreement, or other security acceptable to the City
Manager or the Manager's designee; and
.'
WHEREAS, City through Resolution No. has implemented a program
providing for the opportunity for Development Applicant to defer System
Development Charges; and
WHEREAS, Development Applicant has requested deferral of the System
Development Charge for the above-referenced development project in the manner
hereinafter stated,
AGREEMENT FOR DEFERRAL - 1 -
~
, ./....
,. ',:.. .~.-' '; .:.
, . ..or
. ..;7
....
,j'
.
.
/
NOW, THEREFORE, City and De~elopment Applicant agree that the System
Development Charge will be paid in accordance with the followinq terms and
conditions: "!/'IPIj/ST~/A z.. ' "
l. Descriotion of Proiect:./} rAM/CAT/tJ/'I ()F 5/EV4LTY
J T!3h75 E5I'.'')/;6-11 r;.:O/ ~', . ~.
~
(SEE EXHIBIT Al
2. Svstem Develooment Charo~:
s--'-
/ f. S- S r, tJ (:,
, .
I
3. peferred'Pavment Schedul~: The System Development Charge specified in
Paragraph 2 shall be paid by the Development Appl icant in accol'dance with the
followinq schedule:
(a) The sum of S~~ --. is to be paid at the time the City
issues the initial building permit.
(b) The sum of S "I S-S'r, Ohis to be paid at the completion of
construction as determined by the Citv. City will notify Develnnment Appl icant
tha t the payment is due. - .
. ,
(c) In the event that Development Applicant fails to make the
payment required by subparagraph (a), the City will not issue a Building
Permit or other approval as defined in Section 2-]]-7 of the City Code. In
the event Development Applicant fails to make the payment required by
SUbparagraph (b), no final occupancy approval will be issued.
(d) Development Applicant shall have the right to prepay the
obligations set forth in this contract in whole or in part at any time without
pena lty.
4. Waiver: In consideration for the deferral of System Development
Charge set forth in this agreement, I/we expressly waive any and all errors,
irregularities 01' defects, juriSdictional or otherwise, regarding the System
Development Charge, including speCifically but not limited to errors,
irregUlarities, or defects, if any, in the computation of or underlying
methOdology of the charge.
5, lien: Development Applicant agrees that in the event that contractor
fails to pay the System Development Charge as required by the terms and
conditions of this agreement, City, in addition to the other remedies
specified herein, may place a lien in the amount of the System Development
Charge not paid in conformance with the deferred payment schedule set forth in
Paragraph No, 3, as specified in this agreement, upon the real property upon
which the project is constructed, and that such lien may be foreclosed by the
City of Springfield in accordance with the procedures set forth in Oregon
Revised Statutes 223.505 et. seq. and City of Springfield lien foreclosure
procedures as set forth in the Springfield Municipal Code.
AGREEMENT FOR DEFERRAL - 2 _
/
.
..
6. The real property on which Development Applicant will construct the
project is more particularly described and set forth in Exhibit "A"
Date
Date
/7'3 ~7.S
V\>OP W.'Z1~
D~~LOPMENT APf11jfA~ .
'""-
CITY OF SPRTN(fIELD }~
By: . ~-?' .//v,'~;
/'\)
"; -, s - 1's- "
,
AGREEMENT FOR DEFERRAL - 3 -
"
i
,
.-JOB NO. 94/C,20
.
ATIACHMENT B2
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INOUSTRIAL)
NAME OR COMPANY: ~. 9b~ 77, -
LOCATION: "lS'o fk;t:__"~
DEVELOPMENT TYPE: ~ ~~
, /'
BUILDING SIZE:
lOT SIZF
SQ. Ft.
,
1. STORM DRAINAGE RooF'S t>~",//ys GO To P!:i WE}.i.. 5 - /YO SLJc. c./lA,e6-E-
.IMPERVIOUS SQ, FT. x 0,'5 x . 5-3 ')f!O X $0.209 PER SQ. FT pc" 40 ?J)
fItRKlI"IV-Aor:1'JJSo S/w-!'/r-rlos' 9'-Jo - S'o~o(I.v,e,r,.rlrorWAY)
2, SANTTARY SFWFR-rTTY " ~~3~
NO. OF PFU'S x 0.5 X
(See Reverse)
3. TRANSPORTATiON
(;,0
X $43.26 PER.PFU
{I'1.fr.~~
NO OF UNITS X TRIP RATE X COST PER TRIP
Cot:>€' ,-foe> iVlANloI.F4Cr<A.,(II'IG-
0.5 X 3'6.(,24 X (').15' X $436.19 fAMUCArNI{1STO,eME ~3/ 1.78
Co"~ 110 &/VI, OPFICSt ( ~ ).01= r $TOtrA Go,:).;--. .
0.5 X 1.'1 ~ 0 X.1. ,:1.1 X $436.19 2. 4 2 3./'2
. .~ -
0.5 X
X
X $436.19
$
4. SANiTARY SFWFR.MWM(
NO. OF PFU' S &>0 x $17.19 PER PFU + S10 M~JMC AOiJ,IN. FEE S /041,10
(Use PFU Total From Item 2 Above)
. "
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$ d
I
TOTAl -MWMr snr.. ~ 41. +:!..-)
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ 1<" 12/.01
5. OOl:1I.NTSTRATTVF FFFS,
BASE CHARGE (SUBTOTAl AB~ X ,05
;z:: 4/'
/Mary H.brnig, ~
/. sac e60rdinat~~~'~
B2.SDC
$('8'3".05)
Date: 12 - /:1- 7?
TOTAL SDC $ / 7. s S '1. 0 C.
FIXTURE UNIT CALCULA TION TABLE: Numbcr of Ncw Fixturcs X Unit Equivalcnt c Fixturc Units
_ '(NOTE: For rcmodcls, calculatc onlyew additional fixturesl e
. . . NUMBER OF UNIT FIXTURE
FIXTUR'E l:YPE NEW FIXTURES EQUIVALENT UNITS
.
6athl ub......................................................,...............
Drinking Fountain..,..................................... .............
Floor Dr ain................................................................
Interceptors For Greasc/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswashcr.......... ... ..... .,.. ...,.. .... .,.
Clothes washer .3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commerc.ial Sink/Dishwasher/Etc..
Shower, Single StalL................................................
Shower, Gang.....,....... ... ....,..... ............ ,.,.... ,... ,..... ....
Sink: Bar, Commercial, Residential Kitchen........................ .
Urinal, StaIlNvall........,.,.......,.................,..................
Wash Basin/Lavatory, Single...................................
Toilet, Public Installation........................................
Toilet, Private. ,..,.......... .... ...... ......... ... ...... .... .,.. ....
Miscellaneous: UANJ ro p', \nVK
BRADM!.Y JlAHP IVAS;f
2
1
2
3
6
2
6
6
1
3
.:l 2
1/Head
( 3 2
."$ 2
G.o: ~. 1
,
6
8- 4
I Z
I j
TOT.';L FIXTURe: UNITS
4
Co
("
.1
3 2
2.
3
=
(nO
CREDIT CALCULATION TABLE: Based on assessed value. If im;:>rovements occurred after annexation date in table.
calculate credits separates.
Y-:2r
Ra~e ;:Jar $1,000
Assessed Value
Ahnexed
i
I
II
Ii
I
I
.l
j 973 or before
1980
1981
19SZ
1983
1984
i925
S3.45
3.38
3.32
3.21
3.06
2.92
2.73
_:_t
. Year
Annexed
1985
1986
1987
1988
1989
1990
1991
1993
r
Ii
I
I
Rate per $ 1,000
. Assessed Value
$2.45
2.14
1.77
1.37
0.97
0.61
0.44
0.15
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
X $ =
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
.-
CREDIT TOTAL
DE.t.AY~D
ANoN' E A' 04T/C'N
= $ /\/
/A