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Home My WebLink AboutPermit Building 1999-06-10SPF!NGFIELD RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUILDING SAFETY Page 1 ilob Nurnber: 990639 225 North Fifth SLreet Springfield, OR 97477 LocaEion of Proposed Workz 3372 PARKER LN Assessors ttap #: 17021943 Lot: 39 Block: office: fnspection Line: 7 26 -37 59 725 -37 69 Tax Lot #: Subdivisi-on: 03900 AMBLESIDE SPilNGFIEI-D, Owner: DUKE & DUKE CONST. Address : P. O. BOX 41578 Describe Work: S.F.RESIDENCE Phone #: 338-0614 cirylstate/ zip: EUGENE OR, 97404 NEW General: Plumbing: Mechanical- El-ectrical Contractor DUKES&DUKESC 0065050 PO BOX 41678 EUGENE OR 974040000 DONS LEWIS PLUM 0033076 5OO GREENFIELD ST EUGENE OR 974O4L6 HARVEY & SON OO555B2 4680 MAIN ST SPRINGFIELD OR 9747860 EASTSIDE ELECTR OII777O 38253 BOSCAGE LN SPRINGFIELD OR 9'74 Const. ConEractor #Expiree 03/1,6/01, oe /30 / ee 02 /26 / ee 1"0/OL/01" Phone 45L- 541 1 588-1931 746-7671 7 41,-L499 QUAD AREA: 3RNC OCCY GROUP: R3 HEAT SOURCE: FG INSUL PATH: P1 OFFICE USE -- LAND USE: 111-1 CONSTR. TYPE: VN WATER HEATER: G SQ FOOTAGE: 2458 # OF BLDGS: 1 # OF BDRMS: 3 RANGE: G To request an inspection, call the 24 hotr recording aL 726-3769. A11 i-nspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. wil-I be made the following work day. --- REQUIRED INSPECTIONS --- FOOTING - After trenches are excavated. FOITIIDATION - After forms are erected but prior to concrete placement. ITNDERFLOOR PLITMBING - Prior to insulation or decking. ITNDERFLOOR DRAIN - Prior to cover or placement of concrete. ITNDERFLOOR MECHANICAL - Prior to i-nsulati-on or decking. POST AND BEAM - Prj-or to floor insulation or decking. INSUL,ATION - Floor; prior to decking Wa11/Ceiling; Prior to cover WATER LINE - Prior to filling trench. SAI{ITARY SEWER LINE - Prior to filling trench. STORM SEWER LINE - Prlor to filling trench. ROUGH PLITITIBING - Prior to cover. ROUGH GAS - after fine is instal-l-ed and capped if not attached to an appliance ROUGH MECHANICAL - Prior to cover. ROUGH ELECTRICAL - Prior To cover. SHEAR WALL NAILING - Before covering sheathing wiEh finish materials. FRAIIING - Prior to cover. INSUIJATION - Floor; prior to decking Wa11/Ceiling; Prior to cover DRYWALL - Prior to taping. ELECTRICAL SERVICE - Must be approved to obtain permanent power. cAS SERVICE - After line is installed and line has been connected to a mini-mum of one appliance. Pressure test done at this point. SPRINGFTELD .fob Number: 990639 SPruNGFIELT', Page 2 CURBCUT - After forms are erected but prior to placement of concrete. SIDEWALK - After excavati-on is complete, forms and sub-base maEerial- in p1ace. FINAL PLTMBING - When all plumbing work is complete. FINAL MECHANICAL - When all mechanical work is complete. FINAL ELECTRICAL - When all electrical work is complete. FINAL BUILDING - When all required inspections have been approved and the building is complete. Lot Faces: S Topography: 2 House Garage Setbacks SW 5 18 Lot Sq. Ft.: 5369 Total Height: 27 Lot Coverag'e: 30 t Lot Type: INTERIOR N 30 E 1,2 Item Main Garage Total Value Building Permit Fee Surcharge/admin TOTAL FEE --- BUILDING PERMIT Square Feet x t9'7 5 483 $/Square Feet 69.64 18.34 (A) Value 137,539.00 8, 858.00 1,46,3 97.00 s38 43 15 10 581_.85 PLI'MBING PERMIT --- Item Resi-dential Bath (s) Plumbing Permit Surcharge/edmin TOTAL CHARGE 3 Fee L92 .50 1,92 .50 t5 .4L 207.9L(c) --- MECHANICAL PERMIT --- Furnace Exhaust Hood Vent Fan wood Stove / lnsert /Fireplace UniE Dryer Vent GAS P]PE W/H Mechanical Permit Issuance Surcharge/admin TOTAL PERMIT 4 6 4 12 4 5 5 .00 .50 .00 .50 .00 .00 35 10 2 00 00 80 (D)47.80 --- MISCELLAI{EOUS PERMTTS Surcharge/admin Sidewalk Curb Cut CITY SDC WILLAMALANE TOTAL MISCELLANEOUS PERMITS 0.00 50.00 50.00 2,837 .a7 1, 000. 00 3,957 .L7(E) 4,794.73(Excluding Electrical) unless oEherwise noted --- TOTAL A}TOI'NT DUE --- (A, B, C, D, and E combined) SPRINGF!ELD Job Number: 990639 SPruNGFIELT', Page 3 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT --- This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including Lhe Development Code, regulatj-ng the constructj-on and use of buildings, and may be suspended or revoked at any time upon viol-ati-on of any provisions of said ordinances. Plan Check Fee: 350.19 Date Paid Received By: Plans Reviewed By: AL WARD Date Building Site Revj-ewed By: BOB BARNIIART Receipt Number: 033985os/1,4/ee o6/oe/ee --- ADDITIONAI. COMMENTS --- A SEPERATE ELECTRICAL PERMIT IS REQUIRED DRIVEWAY REQUIRED TO BE PAVED 1 STREET TREES REQUIRED By signaEure, I ataEe and agree, that I have carefully examj-ned the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and aff work performed shal-l- 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 wit.hout permi-ssion of the CommuniEy Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with oRS 701.055 will be used on this projeet. I further agree to ensure that all required inspections are requesLed at the proper time, that each address is readable from the street, that the permi-t card is located at the front of the property, and the approved set of plans w1ll- remain on Ehe site at al-l- times during construction. 6-/O-7r 5l-ture Date --- VALIDATION --- Receipt Number Date Paid Amount Received Recej-ved By €*e2 v"-<27 '?tl -$.$ J9u8l,l1L oR JoB Nu. '??nG9 ATTACHMENT A CITY OF .SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME OR COMPANY:+ :ts1a DEVELOPMENT TYPE:5F LOCATiON: J t%r5+4rt3 v %rZ- BUILDING SiZE: 1. StoRu oRntruReE IMPERVIOUS SQ. FT 2. SANITARY SEWER.CITY SrZr SQ Ft,. 6eoY) z- i- \t (zi) x $0.227 PER SQ. FT. $ dr83'-1) (See Reverse Side) TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP .o x $475.32 x s475.32 NO. OF PFU'S NO. OF FEU'S B. IMPROVEMENT COST: NO. OF FEU'S X $47.14 PER PFU s f 75.(",4- $ 4*1,01 $ zt1 .# s 29.20 <$ $ 10.00 5 Z\Z,LA Z,O 't $l IO x X $ 4. SANITARY SEhIER-t.4t^lMC A. REiMBURSEMENT COST: MI^IMC CREDIT IF APPLICABLE (SEE REVERSE) Mt^lMC ADMINiSTRATIVE FEE x zl't.++PER FEU X Z5.2OPER FEU TOTAL-MWMC SDC SUBTOTAL (ADD ITEMS 1,2,3 & 4)$77 5. ADMINiSTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) X .05 (Vs,; SDC Coordinator ATI-ACH'A.hlPD Date TOTAL SDC s8 T tI _Ewlft , . : ,' HXTURE UNIT CAEeUI -TlOtS TABLE: Number or New Fix' 'ts (NOTE: For remodels, calculate onh-(ne NET additional fixturds)'-r"''" NUMBER OF. NEW FIXTURES FTXTURE TYPE I t X'Unit Equivalent 7 Fixture Units UNIT FIXTURE EOUIVALENT UNITS 4 Bathtub..... Drinking Fountain--.. '1""""""" Floor Drain. e /Head 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 b 4 -_- =T T- ZG lnterceptors For Grease/Oil/Solids/Etc lnterceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher" "" Clotheswasher - 3 Or More"" Mobile Home Park Trap (1 Per Trailer)"'::""""""' n"""p,ot For Refrigerator/lvater Station/Etc Receptor For Commercial Sink/Dishwasher/Etc" 't Shower, Single Stall""""" Shower, Gang.-.--."" iintt a"r, Commercial, Residential Kitchen Urinal, Stall/Wall... Wash Basin lLavatory, Single"""' Toilet, Public lnstallation' Toilet, Private-..---. Miscellaneous: CREDIT CALCULATION TABLE: Based on assessed value' calcul ate credits rates Credit for Parcei'or'Land Only lf Applicable lmprovement (if after annexation date) TOTAL FIXTURE UNITS lf improvements occurred (Rate X Assessed Value)x's- = after annexation date in table, (Rate X Assessed Value) CREDIT TOTAL RUNOFF COEFFTCIENTS FOR STO-RM DRAINAGE (For Estimating PurPoses OnlY) Residential.-- """" O'4 Commerical""""""""""""' O'9 lndustrial:-. O 5 Governmental""""""""""" O'5 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFTCIENT $ Year Annexed Rate per $1,OOO Asldssed ValueYear'. Annexed Rate per S1,OOO Assessed Value 1 989 1 990 1 991 1 992 1 993 1 994 -r-; .1995 1 996 1 997 s1.98 1.55 1.15 o.96 o.B3 o.67 o.52 0.38 o.21 1979 or before 1 9BO 1 981 1982 1 983 1 984 1985', 1 986 198-1 1 9BB $4.27 4.18 4.12 3.99 3.83 :3.68 3.48 3.18 2.82 2.42 FIXUNIT.WPD -T-- _-T-_ -1r7T- 1rr €$Willamalane Park & Recreation District Job. No. PHONE:8 SYSTEM DEVELOPMENT CHARGE WORKSHEET NAME:N-!.- t r&*tc{ ADDRESS:STATE:ztP 1r"ot LOCATION OF PROPOSED BUILDING SITE: Street Address:? Plat Name: \-f Of,\tttS Tax Lot Number:O3lcl: 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t ype definitions are on the back.) A. Single-Family Detached \ Single Family homr! NO. OF UNITS X $1,000 per unit = $t crLD - B. Single-Family Attached X $924 per unit = $ C. Multi-Family Apartment NO. OF UNITS X $692 Per unit = $ D. Mantrfac'trrred Home Park X $699 Per unlt = C- Manufactured home not in a park @ NO. OF UNITS WILLAMALANE SDC 2. SDC CREDIT (if applicable) SDOgayer must tunhstr prool of Wiltamalane ireOit-approval. See 9DC Credit Wortcsheet. $ $ \OD,$ $(D m')3. TOTAL WILLAMALANE NET SDC ASSESSED (lf SDC reduoed for Credit) D lopment Services _v,lD_,ffi Date City of Springfietd Department 9to63q NO. OF UNITS B5t82!2ggL ii7:iE 5418Ii49358 I",. & A ENGIhEEF{II,I'J Ciry Job # trAr:E L ?\ Lltrmnrrrn!1y Serviccs Dr ,uilding Sufcfy CITY OF SPRINGFIELD, OREGbN 225 5ri Slrcc(. "Springlictd OR 974?7 ph. 7i6-l?Jii I,.rb FIgLD Affidavit For Sitc lnvestigation euestionnaire Foundation Sub-Grade Approval for Residential Building site in AnrblesidiMeadows - r*t Addition Subdivision The undersigned hereby affirms that rhe *xcavation, structu*l fiu and morstu,"stabilization methods for.the building site at rhe address shown above was observed byme oran authorized employee of my firm and that the folowinjilm";- l ' 'fhe foundation sub-grade is capable of supporting a minirnum of l50o psf, and isadequate to support the building proposeilfor thiisire. ?" The moisture coutont of the ex!-avation was adequately maintained during the sitepreparalion proce:s and was adequately c,rveredio stauitized moisrure "Jnt.n,prior tc any significant change in-moisiurc content of the sub-grade. 3 ' The site is adequately graded an,c draincd to pre,vtrnt the collection of water in tlreexcavated area during construction, 4' The accompanying report titled "$ite Investigation Questionnaire for ConsulingDesign tlot'essicnals" contB.intng field obseriarions*and instructions rnade ou date) for the buildir,g site was cofilpleted eirher bymyself or hy an employ'ee of my finn under my supcrvision To the best of mvknowledge, the infornration coutairied in that report is conplctc and accuratc. Name of Licensed professional (print),/L4 r c+**gz-tba/L"D f JI 6--1-&'(*- .a a oRBEtOt{ IU ,t9474 Itt o*tetz/s{r-- - \ C,'TY OF SPP'A'GFIELD, OREGO'V 225 FIFTB STREET SPRTNGFTELD, OREG0N 97 477 INSPECTION REQTEST| 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION LEGAL DESCRTPTION o JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor e"f^fu Address ,1 )92 k sCA6€ tle Ci 5F€L0) Supervisor License Number 55 i7 S Expiration Date -o Constr Contr. Number lt?7 7D Expiration Date lc'ul't;C Signa 1S Electrician Owners Name Address Ci ty pnone 15F,-Ob14 sPR.,.-.iFtELl) BLECTRICAL PERI{IT APPLICATION Ci ty Job Nurnber 3. COHPIJTE PEE SCEEDULE BETOV A Nev Residential-Single or MuIti-FamiIy per dvelling unit. Service Included:Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Sertice or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amPs - 601 amps to 1000 amPs- Over l-000 amPs/vo1ts - Reconnect 0n1Y c t--- $ B5.oo ?5 3 $1s.oo E $ 40.00 $ s $ $ $ $ 00 00 00 00 00 00 50 60 100 130 300 40 aSove- $ 40.00 $ ss.00 $ 80.00 see rrBrt Temporary Services or Feeders Insiallation, Alteration or Relocation 200 amps''or less 201 amps to 400 amPs - Over 401 to 600 amps Over 600 amps or fOOO-voFs D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permit $ 3s.oo E.Miscellaneous (Service/feeder not included) -Each installation' Pump or irrigation Sign/Ou tline Light ing-- Limited EnergY/Res --Limited EnergY/Comm SUBTOTAL OF ABOVE 7X% stat" surcharge 32 Administrative Fee TOTAL $2 00 OVNER INSTALLATION The installation is being made on property I ovn which is not intended for sale, lease or rent' Ovners Signature: $ 40.00 $ 40.00 $ 20.00 $ 36.00 @ DATE: RECEI RECETVED B 5 pnone aV/-/?clc) .RINGFIELE, Qfi, 225 FIFTE STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUESTz 726-3769 OFPICE: 726-3759 t"TION t BLBCTRICAL PERHIT APPLICATION ?fod 37 JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI.,ATION ONLY Electrical Contracto Address Ci ty Phone Supervi-sor License Number Expiration Date,!a1 qq Constr Contr Number clg t4, Expiration Date 11 S Electrician Owners Name Address 0 fl ./)v 4rt7{ Ci Phone 11, i - tt z/ 7 7 OVNER INSTALLATION The installation is being made on property I ovn which is not intended for sale, lease or rent. 0vners Signature: DATE: Auu6g0 PgIIF.Rr"oP'r""" Each additional 500 sq. ft or portion thereo f Each Manuf'd Home. or Hodular'Dvelling Sertice or Feeder Ci ty Job Number FEE SCEEDTILE BELOV WORK tems ers terat ions amps amps amps amps/voI ts Reconnect 0nly I.EGALl7n2/DESCRIPTION -,q q-T- --- ol?oo 3 A t-tregot Cos t s 8s.00 s 1s.00 $ 40.00 s s0.00 s 60.00 s100.00 s130.00 $300.00s 40.00 Sum D c. one circuit $ 35'oo Each Additional Circuit or vith Service or Feeder Permit $ 2.OO E Miscellaneous (Service/feeder not included -Each installation Pump or irrigation Sign/OutIine Light Limi ted Energy/Res Limited EnergY/Comm SUBTOTAL OF ABOVE ll state surcharge '32 aamini,strative Fee TOTAL Temporary Services or Feeders Installation, Alteration or Relocation 200 amps'"or less $ 40.00 over 4bL to 600 amps - $ 80.00 Over 600 amps or fbOO voTIs see rrgrr tfiffi Branch Circui ts ) .- Nev, Alteration or Exterrsion Per Pane1 ffie s 40.00 s 40.00 $ 20.00 s 36.00 5 RECBIVED B 2-e', Cc_rffi- .t 2- .Og B This permit is required for any site activity in the flood plaln and overywhere elte alteratlon congiate of Thls SIde To Be Fllled Out by'Appllcant fifty (50) cubic yarde of material or more,and/or i? a dralnageway is affected, within City limits end€n Phone: <//- Z'zg - OGtF CitV €ufrz.e_State : N Zip ?4 g t3l1a5 a Permit Expiration DateDate of Application Property Owner Site Address Address : Springlield, Oregon Journal number applicable Land Uso Application 11-oL-lq-+b Tak Lot: 39 mtr uGB Tax Map No r o tr Supplier ; Material GRADING. Ouantitv EXCAVATION, Ouantity Dostiriation: , Project Supervisor \t \J P'.t- (., Phone FILL, Ouantity , Source Location Supplier: Address *tt c'f E slTE PLAN Reouired Data:Quantitv of matorial, Proportv linos and descrlptrons, Tax map ano - lot number, Sitd addres,s,, Existing contour linos, Proposrid contour lines, Exisling drainage wavs. Prooosed drainaqd wavs. Siqnificant troos aniJ foliaqo, Ground cover, Soil types, gui(dihgs,'Septic systeirs, Sejw'ersiAroas subjoct to flooding, Utilities, Areas subject to land slidos, Proposod sitr: rrnprovemonts. DRAINAGE, POLLUTION AND EROSION CONTROL PLAN- PHONE STATE -IONE STATECITY tr tr tr tr B CROSS SECTIONS, SOILS & GEOLOGY PLAN, ADDITIONAL INFORMATION, REPLANTING PLAN COMPANY NAME COMPANY NAME: PROJECT SUPERVISOR: ADDRESS: PROJECT SUPERVISOR: ADDRESS: Registration Numbert [o-06o . , ExP MOBTLE pHONEz z4/- gt3( , EMEBGENCY PHONE: 3.//- 92 / = {, ADDRESS / o, 8,, NE Sal: gi/'.CE /? FAX iration Date: 3 /-7R ZtP: ?Zqorf _ OFFICE PHOSTATE: , CITY PHONEPROJECT SUPERVISOR: CONTRACTOR NAME I understand that I or my succossors may have future plans for my propony which may be antic.ipatod. or unanticipaled at tttii rime. lundersrand rilaisrin lurure [lans -ay requiro pormirs'ahd'dovilopemontlpprovals lrom the City ol Springfield I understand that notwithiia-noing anv a-pprovat o't tnii Larid and Drainago Alroration P6rmrt (LDAP)' that at tho timo of lppffiiiii" "t-iriuri per.iii or a"pprovali'the City may roview and roconsider all actions which lor mY successors have ,'n-A"it"fen persuantio this LDAP. I undorstand that tho City may as a condition ol any {uture^approval, require the ^ - ^,nooing. inlnging, or -ooiricaiion oi "niiCiioni which I hivo uhdenaken as a rosult bl the city's approval of this LDAP, Ettlz =o ull-o zo E OE UJ h ctz 5 ol 2tIrl I =o( EoUIE5otU GE ol-z E =3I'zoo OEo t Gt-z l8 ct,zso. UJ CE =l- a ul cc:lkzgo Fts M, tIJo- Zo =M, LUFJ IIJ U Z -l d.o oZ cZ 5 By signature, lstate and ag/oe, llrat I havo carolully examinod thb com.ploLed application and do horeby corriry Ihal all inioriarion herein is true a-nd correct, and lturther'conify that any and all work porformed shall be done in accordance r"itn tnu Ordinances of rni City ol Spr.ingfield, applicable'City Srandard specificaiione and Drawings, and the laws ot lhe Siir, oi Or"go; pertaining to tne *drk d-oscri6ei'horein.{ tuhher conify ihat only.contraclors and employees who are in compliance with ORS 701.O55 will be used on this projoct' The City may inspect the work sirc described in this pormlt at any limo during a ono ysar poriod f ollowing rho receipt bv the City of nbticd ol complotiorr ol rlro doscribod woik and rpeclfy, ct tho City's sole desocration,.any additional resloralton work requirod to roturn the sito ro a standard acceptable to ihe-Clty, The permittee will be norified in writing ol any wor.k iiquireA'anO wlit trave thiny (3O) days from the daie'ol the notlce io complete the work. Work not completed at lhs end ol rhd rhirry days will bo porl6rmed try the City End th€ costa will be billed to the permittee. I lurthot agroo to onsure thal all rcrluirod ions ths stroot, ond Ihe sot ul plans Signature q are rcqucltcd ai tho propor timo, that projoct adclross is roadable ltonr on lhe sllc at. all limos during conslructron. &5 b'Jua,""7^w-L rG + 11063? 5 Dato 33qgo art % ] PRI HOTIILD b DRAINnGE, O Stornr, E Ditch, fl Ctrlverl, fl Nirrrrralw@ b- I eqq?6fr2canelNo WETLANDS, Descri FLOOD PLAIN, Zone Lrnrty P r00.001 To 200 000 2OO,OO1 CUBIC YARDS OR MORE GRADING PERMIT FEES: UP TO 1OO CUBIC YARDS 1O1 TO 1,OOO CUBIC YARDS 1,OO'1 TO IO,OOO CUBIC YARDS 1O,OOO TO lOO,OOO CUBIC YARDS 100,001 To 200.ooo 5 2 0.00 s30 00 s 40.00 $40.O0 For the trrst 1O,0O0 cubrc yards, plus $2O.O0 f or eaclr adctrtronal l O,OOO cubtc yard:; ()r lractrorl thereol S22O.O0 For tho f irst 100,001 cubic vards, plus S20.00 f or each additional '1 0,000 cubrc yards or lracltotr thereol S34O For the lirst 2OO,O0l cubrc yards. plus $6,O0 f or each ad(lrtronal 10,000 cubic yards or lractron thereof s 30.00 $30.OO For the lrrst l OO cubrc yards, plus S14.OO for each a(rdrtlonal IOO cubic yards or lractrorr (llereol S 156.O0 For ttre lrrst 1,0O0 cubic yards, plus S 1 2.OO lor each additional 'l ,000 cubrc yards o, lractr()rr theroot $264.00 For tlre lrrst 10,O00 cubic yards, plus $54.00 f or eaclr addrlronal 10.O0O cubtc yards or lraclrott tllereol S75O.O0 For the f rrst 'l OO.0O l cubrc yards, plus S30.00 lor eaclr arlrjrtional 10,000 cu[ric yards ()r lractrorr the,eol tt 'P2''' '-oarc'4{.:1111 ?94 o^r",Q,/C% Estimated Volume Plan Check Fee: PLAN CHECK FEES: UP TO lOO CUBIC YARDS 101 TO l,OOO CUBIC YARDS 1,001 TO 1O,OOO CUBIC YARDS lO,OOO TO lOO,OOO CUBIC YARDS Received By: .{.,1jtuf11ni.- J,,O Wl, Grading Permrt fee Received by: Receipt No Date: {tfl n Date Date r Date Date K, L ?) Marntenance Pla n ningl Engineering Building: s e To Be Filled t o Staff lllutIL ozo l- ct2I a UT E =LrlG al,zo l-o HU, = t Permit Nunrtrr:r ReqL r i red F inaL-hslexlr0-os* lssuecl by:_______ Planning: E t'tg irtet-'r rtrr 1 Date Dater Date Date Dat c Eh-rrldrrrg: M aintenarrce: tr Land and Drainage activity as outlined in this permit has been complereci in accorcJance witlr the provisions of this permit. tr Land and Drainaoe aqtivily as outlined in this permit has not been compleled rn accoroancewllh th€ provlllonl 0I lnll pormlr, tr Lar-rd and Drainage activity wa0 psrform0d prror to application for rhis pgrmrl, Accepted by Date tuoz EaLloo ilorr gse FLOODWAY, FEMA Community Panel No.: , Dtrre Receipt 16' r:33''l8O Dare: qlV l't1 ,la/ IUa z Eo