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Home My WebLink AboutPermit Building 2007-5-4 . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00360 ISSUED: 05/04/2007 APPLIED: 03/12/2007 EXPIRES: 11I0412007 VALUE: $ 169,533.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5783 MT VERNON RD ASSESSOR'S PARCEL NO.: 1802030006200 SPRING FIE TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence -lot 196. SAME AS COM2007-00355 5795 Mt Vernon Residential Phone Number: 541-228-1081 Owner: HA YDEN ENTERPRISES Address: 2622 SW GLACIER PL #110 REDMOND OR 97756 Contractor Type General Electrical Mechanical Plumbing I CONTRACTOR INFORMATION I ~Oli" Contractor <0o.\)\<~M.~~\'lc\ Expiration Date HA YDEN ENTERPRISES ~~(\ ,e.~o O<~1l0\ ~~ 07/29/2007 M & W ELECTRIC 1N~f).RP~~ tU'OS~~f!J?'; '0 06/19/2007 PACIFIC AIR.~~&~~ ,,\~o<;>O \)~~QJ~ 0 <\)\05 03/25/2010 DENNIS sc&\l\T~d~~e(\\~':-\o~<~,,\es Q\~'Uil~O~~n 05/05/2010 ~~\~\C' '-~ffiHN~';:;~~ :-;5 - ~'\\;C>" I'\O~~ 'louU/!\ e(\\~~' . o(\Ut,( ~), 10000. ~~!'OIl~IR~a~e~ O.?,'~~' 2 Lot Size: R-3 Ce."~ \:lIlf1N'of,.sttn~re: 24.00 Sq Ft 1st Floor: U (\\)~'O ype oi"eat: Forced Air Gas Sq Ft 2nd Floor: VB Water Type: Gas Sq Ft Basement: Range Type: Gas Sq Ft Garage/Carport Energy Path: Path 1 l','lJ't Other: Sprinkled Building: n/a\\t. ~~H'upant Load: _,,,c: I\- \ _ "n; I DBwwiM~iVn::N:r U'/HORMA 1!':ON:l\J\1 Ic:~~" I V I" "J"" 1fl,t,U I v{' \\\\S[.~'lt.\) \\~ \:1' ~~f\~UQ f\\9:~~~1 pist: Q\\ \S Clll~\~~e +~~ ~\Itt\\)\).. I ~P~'Rie~ I!trQ$\!l.q d: Yes I%'l.or Lot Coverage: 29.80 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 3 Phone 541-228-1081 541-754-6171 541-672-9510 541-459-0110 3,513 641 898 408 REQUIRED PARKING Fullv Improved Yes DownspoutslDrains: Curb and Gutter For this parcel in Jasper Meadows 3rd & 4th Add, it is the recommendation to the Building Division, by the City Engineer: "that final occupancy should not be given until the subdivision is accepted by City Council". Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 14.00 15.00 5.00 12.10 0.00 Total: Handicapped: Compact: Subdivi.'iiOIl Not Ac:cepted Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I Sidewalk Type: Notes: Private Street Paee I of 4 2 _&PAIN~.lF._ ~ I.. Utt.. a-.. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction DwelIines Garaee V Wood Frame Garaee Fee Description Plan Review Same As -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 80/0 State Surcharge 2 Baths One or Two Family Addressing Assignment Building Permit Dryer Vent Exhaust Hoods Fire SF Fee - Residential Fireplace (Listed) Furnace - up to 100,000 btu Gas Outlets 1-4 Plan Review Major - Planning Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 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 Reimhursemenl Storm Drainage Impervious Area Vent fall WilIamalane Single Family Total Amount Paid . I Valuation Descriotion I $ Per Sq Ft or multiplier $103.00 $27.00 Square Footage or Bid Amount 1,539.00 408.00 Total Value of Project Fpp< ~ Amount Paid Date Paid $200.00 $10.00 $ 134.65 $72.36 $99.93 $254.00 $31.00 $793.15 $6.00 $9.00 $97.35 $15.00 $12.00 $4.00 $198.00 $106.00 $38.00 $554.14 $728.74 $10.00 $961.52 $91.61 $128.41 $70.06 $836.32 $189.58 $597.40 $12.00 $2,303.00 3/12107 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 5/4/07 $8,563.22 Paee 2 of 4 . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00360 ISSUED: 05/04/2007 APPLIED: 03/12/2007 EXPIRES: 11104/2007 VALUE: $ 169,533.00 Value Date Calculated $158,517.00 $11,016.00 $169,533.00 03/12/2007 03/12/2007 Receipt Number 2200700000000000329 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 1200700000000000506 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00360 ISSUED: 05/04/2007 APPLIED: 03/1212007 EXPIRES: 11/04/2007 VALUE: $ 169,533.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Plan nine Review 03/13/2007 03/13/2007 I Plan Reviews I 03/13/2007 APP 04/26/2007 APP LLH TAJ Structural Review 03/13/2007 03/27/2007 APP LLH Per letter from Hayden Homes dated 4/25/07, each house shall have, 1. 3' walkway from porch to street, 2. extend porch 4' from garage facade, 3. windows in the garage door. For this parcel in Jasper Meadows 3rd & 4th Add, it is the recommendation to the Building Division, by the City Engineer: "thai final occupancy should not be given until the subdivision is accepted by City Council". Same as approved by Don Moore Public Works Review 03/13/2007 04/05/2007 APP MS To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~ Rpollirrrl 'nsnections I 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. Final Electric: When all electrical work is complete. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to noor insulatiou or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough iu iuspectious have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Undernoor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Paee 3 of 4 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00360 ISSUED: 05/04/2007 APPLIED: 03/12/2007 EXPIRES: 11/04/2007 VALUE: $ 169,533.00 Status Issued 225 Fifth Street, Springfield, OR 541- 726-3 753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Undernoor Mechanical. Prior to insulation or decking and including required testing. Undernoor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance, Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing, Presure test done at this point. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric 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 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 at all times during construction. ~'~ ~ S/cI/rJ? Owner or Contractors Signature I Date Paee 4 of 4 CITY OF aNGFIELD SYSTEMS DEVELOPMEAORKSHEET LOT SIZE (SF): 3513 'I IrIl "-l Cl o U c.: ~ rIl o ~ JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS COM2007-00360 Ha~den Homes 5783 MI Vernon 18020300 TL 06200 SINGLE FAMILY RESIDENCE I BUILDING SIZE (SF: 1539 L STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I 1780.00 I $0.336 I = I $597.40 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 I 0.00 I I $0.336 I I 50"10 I = I DISCOUNT $0.00 ITEM I TOTAL - STORM DRAINAGE SDC 2 SANITARY SEWER - (:fTY 5597.40 $597.40 I 1070 A. REIMBURSEMENT COST: I NUMBER OF DFUs I x COST PER DFU 11091 I 28 I $26.03 S728.74 B. IMPROVEMENT COST: 1 I NUMBER OF DFU's I x I 28 I $19.79 S5S4.t4 11092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, SI,282.88 J J TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRlPFACTORI I 9.57 I I I I $19.81 I 1.00 I S189.58 1093 B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP F ACTORI I 9.57 I I I I $87.39 I 1.00 I $836.32 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = , SI,025.90 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER ~F FEU's I x ICOST PER FEU I $91.61 = S91.61 I 1054 B. IMPROVEMENT COST: 1 INUMBER ~F FEU's I x ICOST PER FEU I I $961.52 = S961.52 :j 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1 1054 MWMC ADMINISTRATIVE FEE SIO.OO 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =1 SI,063.13 , SUBTOTAL (ADD ITEMS 1,2,3, & 4) =1 $3,969.31 -I 5. ADMINISTRATIVE FEE: I SUBTOTAL I x ADM. FEE RATE 1= CHARGE I $3.969.3 I I 5% $198.47 TOTAL SANITARY ADMINISTRATION FEE: , 128.41 11079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $70.06 111078 Matt Stouder 4/512007 TOTAL SDC CHARGES =, $4,167.78 I PREPARED BY DATE I . . . DRAINAGE FIXTURE UNI'!..<DFU) CALCULATION TABLE NUMBER OF NEW FlX11JRES x UNIT EQUN ALENT - DRAINAGE FIXTURE UNITS (NOTE, FOR REMODELS. CALCULATE ONL V TIlE NET ADDmONAL FlX11JRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 2 0 3 = 6 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE lOlL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER I MOP SINK 1 0 3 = 3 CLOTHESWASHER - 3 OR MORE (EAl 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG I WATER STATION I ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETe. 1 0 3 = 3 SHOWER. SINGLE STALL 0 0 2 = 0 SHOWER. GANG (NVMBER OF HEADS\. 0 0 2 = 0 SINK: COMMERCIAURESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINIDOUBLELAVATORY 1 0 2 = 2 SINK: SINGLE LA V ATORYIRESIDENTIAL BAR . 2 0 1 = 2 URINAL. STALL I WALL 0 0 5 = 0 TOILET. PUBLIC INST ALLA TION 0 0 6 = 0 TOILET. PRlVATE INSTALLATION 3 0 3 = 9 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S I 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 28 :1 .EDU (Eauivalent Dwellin~ Unit) is a disc~ eauivalent to a sincle family dwel1in~ unit (20 DFlJ's) set atl671!ll11ons ocr day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE L YEAR CREDIT RATEJ$I,OOO l ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 2 BEFORE 1919 $5.29 (Enter I for Yos, 2 for No) 1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT'! 2 1980 $5.19 (Enter I for Yos, 2 for No) 1981 $5.12 BASE YEAR 2005 1982 $4.98 1983 $4.80 CREDIT FORLAND (IF APPLICABLE) 1984 $4.63 VALUE /1000 CREDIT RATE 1985 $4.40 SO.OO x SO.OO - , SO.OO 1986 $4.07 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $3.22 VALUE / 1000 CREDIT RATE 1989 $2.73 $0.00 x $0.00 0 1990 $2.25 1991 $1.80 1992 $1.59 TOTAL MWMC CREDIT = SO.OO 1993 $1.45 1994 $1.25 I99S $1.09 1996 $0.92 1997 $0.72 1998 $0.48 1999 $0.28 2000 $0.09 2001 $0.05 ZON LiJ2.. INITIALS ~JVl DATE . ~-.n, SOURCE I'Y'I <:.. II ;I~~ 115 FII1TH STRElIT . SPRINGFIELD, OR 91477 . PH:(341)7l6-375J . FAX: (541)716-3689 - - -- . ELECTRICAL PERMIT API,'l.;1CATION . City Job Number Q.. n ,. ~ of) t. =.;r..-,"'......;..".............. ...-."--.... ..,~.'......"sr"~)~~~ 1. ,t+~~~~~~'1:tf\J~,\D~-t{ LEG\cAOV;300 200 Amps or less $ 63.00 201 Amps to 400 Amps $ 75,00 ~'18l!:"l Hw<( 1<{ Sw 401 Amps to 600 Amps $125.00 . _ ATrI;:NTIO~!\!)_MaW9ewmfes you Iv $163.00 All..c...u Phone g.f/-7:::'~~1" rules ~019~WelPegon un $375.00 . .. '-.jotitication c&if~'fI.~ rules are set'f:~, $ 50.00 In OAR 952-o0t'OO'1Q~~_)f,"1'ln,.~w ,. ~_~ '1~N $. 0090. You rrla~~~~l~ti.~,,~W~~~ / calling the center. {Not~l' thti te'~'i'~ 10/ Of nllmherfort~~~tll'M9N'O~lflcationon 200 Amps ar./ess,,_2344). 20 I Amps to 400 ^",ps . 40 I Amps to 600 Amps , NonCE' i/~ THIS PERMIT ~:~::.:tiOnorE:rtensionperPane1 // . · "y" ~R '\!Im........'!\~~~f.r'" T~I' ~ \/' ,:-."'v IZED LiI~i(c[^~~irculfbrWillRK Owners N e \. ~~~ . I,.': ;AyD P~Eill~~!~~1t~~~~~~"i~"',m;,O:"i:;.::,..,~...".~~~'".. . ...., , - , r; ~ /', 1Jr: E. 1''MISt2I1...eilmlS~~l~de'r;!lQ 'j)H:JU'didf":'Eacli In'18Uiiti~"'jJ ;~dreSS . ,./- 'p~:J ii~1 :~'::;::4"'E~,~,~..~..~...L~.PB::::;'.."""..~.."""~ SigulOut1ine Lighting $ 50.00 Umited EnergylResidential $ 25.00 Umited Encrgy/Comxnercial $ 45.00 Mini~=,~~:~i~~:~;:;;:::~=::;:~~;;.<Surch.A ' 4. ?f$~~twM~Qr~VE:ftt%f.~~ltt~~~~~i.0it~~~: \ A. [) ~.. .,~': .~. -..:...n.:' ;.,c',{.<g..~~., "",~r 't:'li.,~;;:J-~_..,.....,....,.JIC:~[},~~'I..~".~"'.. ~ . . .~~:;::~s:~~e=-..'..... ",,'~-.." ..... '-", . \\.~' .D.,~t1 10%AdministrativeF~ ~ W T91'JU:, ~P1() -\-et~ Shm<d Drive(T:VBulldIDg FO~Vbif(itAPPI~T~1\ 1\ 'L, O1aldSNIHdS dO X1I~ 689~9.LltS IVd 60:0T aa1 90/IT/LO l{>~ ~E~C 0 .~~k . Permit, a ~ non-transferable a~d ire if work b not st~rted within 180 days of issuance or if w'ork is Suspended for 180 days. 2. ~~~~~~~~fi!?l~~~ Electrical Contractor MttJ flJ.,l ~c..- Address City Supervisor License Number Expiration Date ConSIr. Conlr. Number lo73<P7..... &/,c,/;>>rr Expiration Date Signature of SupOIVising Electrician OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent Owners Signature: Inspection Request:. 726-3769 J 100 IP1 Date 5'-4- ~601 jH.:,~.~.j"~:,.~".. .....,.',.;.-:'.r,.p.;r:::C.::~D~~~~BEt()~i\;i':iC.H~:,,~,,:.JI~.~J"~~:1:.-~ 3. ~~~~~~;~~~ilir~~"~_h~~~~~~i~..~;~.~~f~~~.e1ti~1ii~~\} A. ~.Nfi1i~U.~~::~1;~_~~~~~~:!$'~~iir€4~*] ...:<'-.'.......,. ._..... - "-.~"'~C_lI"'ll"_...~, ,. _. .__,,__.._....,0: ~.,."'-...,.....~~-_.....-......"...,~.:..~....= ._~- -- ..... "-,,,"",_._.=~ --- -~-...~" . -'-'-'------~---._._.......---._._.- Service Included 1000 sq. ft. or less Ench additional 500 sq. ft. or portion tb.ereof . l. $106.00 ~cD I}/f 19.00 ~(J) Each MsnufBct'd Home or Modular Dwelling Service or Feeder,'" ' $50.00 !'~"':-\';{l';.-t(;."~~;:.::,!:f1~~~,,,~~i:~;J:"Y5i~~': q1~~~..;~~rS~4~.~::rii'.t,~;.1I'!1.. ~?"~~.::$.~:!t",,~;i:~'f".!"::'~ B. l:siI'v"'S'M:]1eecre'h:"i'~II:iii!lD':A1~tiQjjs~j:',ReJoi!Mll'fif)i,',; :c..,.,~,;,,~~:~:'€w~~:iS~:1::!:\:l.'j-~;.;,!;~~.-:a:~i.\~~1s::....~"-:'.~_~:iI;>:~~~...I;':Ia:'lji~:;~.QJf~t $ 50.00 $ 69.00 $100.00 Over'600 .>\mps or 1000 Vollll see "B" above. . ",' _.... --or, ""-"-IS'Io;t:t:!!j- ~.,,- --"......1...;;l~.. .~,.... "'''-,."",,-.,~..- .,.......... -.....~, -_~, "'0 c'.."" "" ..,..".~",,~'" !>-"-""..""".,)" -"","""'i""-'~"'~"''''''''"''''"'''" D. ':k::Br;ncb:.~GifMm:t;F"%1t-~~~;f,;li~~f:f.-1;!!i...';j;~~~~?'.Il:~~:nf.:;-'!.~"E'I;-9;~~~" a'~"'Jl....r.;:;,"'';.i;-'k'~~.'''\'''..i.,~,..1,'lo-''''A'!i:.:::.l:tllrJ:;U!;Ri~jli;'i.~1~.:li5l/-l.'li.1fl1~~]l:$o~~ $ 43.00 225 Fift.h Street Springfield;Oregon 97477 541-726-3759 Pbone . -~_"~'lILl? I.!t... ,_ . III.. '" .. of Springfield Official Receipt Welopment Services Department Public Works Department Job/Journal Number COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 COM2007-00360 Payments: Type of Payment CreditCard cR~ccinll RECEIPT #: 1200700000000000506 Date: 05/04/2007 Description Addressing Assignment Willamalane Single Family Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Fire SF Fee - Residential Building Permit 2 Baths One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Fireplace (Listed) -Mechanical Issuance Fee- 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 Plan Review Major - Planning + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By HAYDEN HOMES Item Total: Check Number Authorization Received By Batch Number Number How Received djb 072733 In Person Payment Total: Paee I of 1 1:38:21PM Amount Due 31.00 2,303.00 106.00 38,00 97.35 793.15 254.00 12.00 12.00 9.00 6.00 4.00 15.00 10.00 597.40 728.74 554.14 189.58 836.32 91.61 961.52 10,00 128.41 70.06 198.00 72.36 99.93 134.65 $8,363.22 Amount Paid $8,363.22 $8,363.22 5/4/2007