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Home My WebLink AboutPermit Building 2010-3-10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00141 ISSUED: 03/10/2010 APPLIED: 02/02/2010 EXPIRES: 09/10/2010 VALUE: $ 226,660.00 Status Issued 225 Fifth Street, Springfield. OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1508 S 57th St ASSESSOR'S PARCEL NO.: 1802041401204 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence, Lot 4 Morning View :..<<,~..,;~~:'~r':".' . C~,'" Q?-.~' S,dewalk Type:",,,.:: 'l'l '" C b'd 7' :.r ,1"<- ~(), .~. ur Sl e , , '. Dow~'8t~t~~ \<b .<;:u'rb and Gullet' ~01\C~' ~I'i ~,,~\..\ 1"IS? ~t.() ~()?> " '" '. ,,,IS ~~i\lt.() 1j6~~S ~~~~()(), . ~Ij' ~\'.~c.\'.\) \'.?-I()\)' c.()~ 'eel Qf>.'/ ? f>.~'/ ~ Owner: SW ARTZLANDER JAMES A & HOFFMAN BETT Address: 3173 PHEASANT BLVD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION . Contractor Type General Electrical Plumbing Contractor License REALITY HOMES INC 166318 POSITIVE ENERGY ELECTRICAL CONTRA185788 DENNIS MICHAEL HILLESTAD 185088 . I BUILDING INFORJ'\1A TION ~ # of Units: 1 # of Stori~s: s 'IOU \0 I Primary Occupancy Group: . R-3 HetJl~l3oP~f);~<<tU~I\\~\'l\ 24.00 Secondary Occupancy Group: U. Ole<dO~~'\IWll\,'ti'i'ie set \0 Q\_ Electric Primary Construction Type t.~~' oO?\e~,I~'lfl~t?- 9C,'2.'0 '0'1 Electric Secondar~' Construction Type: P-~ ~ (u\eS a l\\el. -m.O~;ll.~\I~ \"e lule~e Electric # of Bedrooms: \0\10" ca\\!:ll\ C~\.OO\~IWrtW\il~tlli \ele?"O \.\O{\ l'IO\'\' 9C,'2.'0 :o,AifI. "'e~lll! ilAlJ\;!:\Ca No Op..?- t(\e.'1 O"'~\\ll'" i@.~ \" g 00 e.\\il\<d INFORMATION C :oel t\Ut(\ cel\\e 18.00 5.00 7.00 10.00 21.50 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: . .... # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Spedall nstruction: Fully Improved " . " No ':'" , Storm water to curb via n'eephole Notes: Paee I of 5 Residential Expiration 1,>ate 09/16/2011 03/09/2011 01/09/2011 Phone 253-926-6822 360-885-4479 306-931-2077 Lot Size: 6,098 Sq Ft 1st Floor: 2,065 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport 708 Sq Ft Other: Occupant Load: 2 Yes 44.00 REQUIRED PARKING Total: 2 Handicapped: Compact: SPRINQF:U:u.:D ~ ~- Status Issued 225 Fifth Street, Springfield, OR 541- 726-3 753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriution Tvpe of Construction Garaee/Misc SF/Duplex U VB Utilitv R-3 VB 1&2 Familv Fee DescrilJtioll Plan Review Residential + 12";', State Surcharge + 5% Technology Fee 1st Appliance 2 Baths One nr Two Family Addressing Assignment Bnilding Permit Curbcnt Permit Exhanst Hoods Fire SF Fee - Residential Overwidth Application Fee Plan Review Major - Planning Plan Revie",,' Residential PW Disc - 2nd Permit Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Compliance Charge SDC MWMC Imprnvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Tran Reimbnrs-Residential SDC Trans Improvement-Resident SDC Transportation Admin Sidewalk Permit Storm Drainage Impervious Area Temp Power 200 amps or less Vent Fan Willamalane Single Family Total Amount Paid I Valuation Description ~ $ Per ~qFt or multiplier $37.72 $96.83 Squa,'e Footage or Bid Amount 708.00 2,065.00 Total Value of Project ~ Amount Paid Date Paid $725.24 $239.60 $119.93 $79.00 $337.00 $38.00 $1,225.64 $88.00 $13.00 $138.95 $45.00..:Ji $211.00 .. $71.43'. $-30.00 $134.00 $100.00 $507.07 $666.84 $10.00 $22.63 $1,333.57 $101.97 $176.08 $211.21 $931.65 $80.09 $88.00 $1,338.55 $63.00 $45.00 $2,858.00 i.;." ,':i'l; 2/2/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/1 0/1 0 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/10 3/10/1 0 3/1 0/1 0 3/1 0/1 0 3/10/10. $11,969.45 ,'" .... Paee 2 of 5 CITY OF SPRINCFIELD Building/Combination Permit PERMIT NO: COM2010-00141 ISSUED: 03/10/2010 APPLIED: 02/02/2010 EXPIRES: 09/10/2010 VALUE: $ 226,660.00 Value Date Calcnlated $26,705.76 $199,953.95 $226,659.71 02/03/2010 02/03/20 I 0 Receipt Number 1201000000000000096 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 1201000000000000219 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00141 ISSUED: 03/10/2010 APPLIED: 02/02/2010 EXPIRES: 09/10/2010 VALUE: $ 226,660.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Plan Reviews ~ Structural Review 02/23/2010 Structural Review 02/03/2010 Initial Review 02/03/2010 02/03/20 I 0 APP LLH Structural Review 02/03/2010 02/03/20 I 0' WI KLK Plan nine Review 02/03/2010 APP DDK 02/04/20 I 0 Public Works Review 02/12/2010 APP LKW 02/05/2010 Structural Review 02/17/2010 WE KLK 02/17/2010 Structural Review 02/22/2010 02/22/20 I 0 WE KLK ,j , Structurall~eview 02/23/20 I 0 02/23/20 I 0 APP KLK Adjusted Value to minimum default value of $226,659. submittcd as $200,000. Customer to Sign Elcctricnl Application and Homeowner Affidnvit; Planning nnd Public Works This lot is almost at maximum coverage - 44.20/0 out of a maximum of 45%. This is bnsed on 2773 sf of building on a 6280 sf lot. Overwidth drivewny permit/approvnl of overwidth by Richard Perry on 2-11-2010 Missing (I) set of Engineer's full-size plan pages L-I, D-1, N-I nnd lIoor joist layout pnge 1 of I. Phone conversation with engineer and contractor, they ,",'ill provide missing pnges. Received pages L-I, D-I, N-I and flOOI" joist layout 1 of 1 pages, but the engineer's pages L-I, D-l and N-I arc missing the required engineer's stamp. Phoned engineer, he will email pdf letter nuthorizing use. 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. l...jeolJireCUnsoections ~ Erosion/Crading Inspection: Prior to ground disturbance and after erosion mensures nre instnlled, Pnee 3 of 5 CITY OF SPRINGFIELD "" Building/Combination Permit Status Issued PERMIT NO: COM2010-00141 ISSUED: 03/10/2010 APPLIED: 02/02/2010 EXPIRES: 09/10/2010 VALUE: $ 226,660.00 225 Fifth Street, Springfield, OR 541.726.3753 Phone 541.726.3676 Fax 541.726.3769 Inspection Line 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. Post and Beam: Prior to fioor insulation 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 in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to tapiog. ~.. ";.,., , Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Roof Sheathing/Nailing: Before covering sheathing with finish material. Final Building: After all required inspections have been requested and approved and the bnilding is complete. Underground Plumbing: Prior to filling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is iostalled but prior to backfill. Underfioor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. 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. Underfioor Mechanical. Prior to insulation or <Iecking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. I',' Temporary Electric: Approval required prior to Utility Company energizing pole. UfoI' Electrical Ground: Install ground rod at footing and call for inspection in conjuction with footing and/or foundation inspection. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Page 4 of 5 CITY OF SPRINGFlELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00141 ISSUED: 03/10/2010 APPLIED: 02/02/2010 EXPIRES: 09/10/2010 VALUE: $ 226,660.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ..,' Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Curbeut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected hut prior to placement of concrete. 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. I YnttV, fO.d 0 . Date "r" . i Paee 50f5 ~trQctuml Permit Application , ......;~-....~ , lc"i _ _ -:.-. 't~ '" ..~~._':;i"T~'. ':':;1: ~ '. ,,-, Gnw OFSPRINGF:lE:i::D~OREGON'll\::?~:, .!l;-:J,.-.'t_f"."'l' - ... - ~ I..... <;.. . :D~PARTMENT usepNlv - ~~t:o? Ii{ I 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726.3689 Date: 2 - Z - ( 0 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ~ c\ol~~ . -:"i> 'l.'llu,lo?q ~~~*{q:t~;Ji?i11riasV~~G,o'ftit~G:t08:U.~f.9J~,MA1]9J.J1f~i5(l?,~~1~~t~1 Name CCB License Number Phone Number 4/0 sit,,, eo 2:rtE ~~ ~ H; l( e: '5~ t f Ion.. b;....i .~e~r:fa \~ ~~~ ~,~ ,,;: " :. ~/~',;,' ,)~:_\~12qC'A~)~'QY~~N M.I;N_t:;~)~)~_~'R9"V AA~~ttiliih.fi~,;1i?J~~f~ This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Ves 0 No Property is within flood plain: 0 Ves 0 No -:"1i >>~'- ......"'"....,~-.;.,,';tt "...-...." - .".. .' - "'....._......-"'._".7"'~--',.,-,., -' .,.." "-"<" '.'~ .._"_..~~~'~j;".., '.l,~': ".~ l' ,,- ;,\.,;,~t~J.iij:).;,\'/i--'ili;CA TEC;>OBY.tOf.i,c.oI-!~;r;~Uc!n.9fi.~":,:W~t)llJ,1i) esidential D Government 0 Commercial ~r;~:~~j;~::}~'{~,Q_~~1,S.I;T.~'tiN~~q'~_MAti9~Y.~~ pIC.9):A:T:'.9~~~J~ti1;ri.~~:~~ 08 City: Subdivision: Reference: I City: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate .family, and is exempt from licensing requireme sunder ORS 7 O. :, , E-mail: cca license no.: Print name: O,^~S :lAc.. Signature: Electrical Plumbing Mechanical pel t"c.t c;~~ <:> "'S7-7Z2-7:Z.<;, 0 .- f"-;l F; - ,:::,~':,,;:'"::Ii';"FEE 'S<::HEOiiIE":'i', -.> ;',0'0';-'- :. .' "[I :~Y.~!~a.~i:9'n!IQfo'~~a:<iipAi(~~~~~j}.~:~~].#1;W ~;~1{~~At::N, 11;~?:t;,.~~~~:~~ (a) Job description: Sl.vf~- ~Mf('V' Occupancy 12"1 / LA , I Construction type: /_ VIS Square feet: Z 7 7"3:- fJrt.J>~ Cost per square foot: n ~lYJ Other infonnation: .~ Type of Heat: ELt:'- /W;1LL Energy Path: -la-1Tew 0 alteration 0 addition (b) Foundation-only pennit? 0 Ves ...B1'fo Total valuation: $-2()() k ~~}B.~!i4)~g~tee_~~;~~1ifw~~r~~\~i~~.~;;~~1.~:~~~~\~t ::\\,,~_':'j'~~;~!: ~f.;1 :f,:~\.:~' (a) Penn it fee (use valuation table): $ (b) Investigative fee (equal to [2a]): $ .. (c) Reinspection ($ per hour): $ / (number of hours x fee per hour) . (d) Enter 12% surcharge (.\2 x [2a+2b+2c]): $ (e) Subtotal of fees above (2a through 2d): $ 'j3'~pl''X;i:l~;'';\'!~;1~_;(F~'t'~'ti;ki't;~''k'<j:.:-,t~'L-~i\'C!JJ?,'~~h.@';;;I:;~::j...,.~;t:~~'" ~j'.~' . ~~\.r:eY_I.~W: ~~~S~i..1~)"{<i..:'.ii~ ;.~W ,"h;E;';'~i~~$s:..,,~.~;JX;;~A.: ..<:....1;,: ;~t~l ~.}'/1 1..... (a) Plan review (65%x permit fee [2a]): $ 7Z~ ~ (b) Fire and life safety (40% x permit fee [2a]): $ (c) Subtotal of fees above (3a and 3b): $ ~~:~M.i~~~~i~_~~~~(;.~sJ t~~{z4r~~ri~~:~1fta;~I:~f.;tfi';';::,:,:L~~r'~"!~~~~~<:<;t1i.:.:.' (a) Seismic fee, 1%(.01 x penn it fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): S . I ~~ ~.to \~cYP Electrical Permit Application I<mwCIDW~~~ 225 Fifth Streett Springfield, OR 97477tPH(54I)726-31S3tFAX(S41)726-3689 I~ DEPARTMENT USE ONLY =1"\2.010- 00 \'-1:\ Penn it no.: to Date: :;z. Tbis permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started witbin 180 I!.~y.s of i"~!!.n~~ o.r i( ~".rk. ~ slI~pe_nl!.e<I. for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION E9 Residential I 0 Government' I 0 Commercial JOB SITE INFORMATION AND LOCATION FEE SCHEDULE Number of inspections per item () Qty. Cost Total ... cost Residential, per unit, service included: 1,000 sq. ft. or less (4) , $134.00 $JSl./ Each additional 500 sq. ft. or portion 4 $ 25.00 $lDe thereof Limited energy (2) $ 32.00 $ Each manufactured home or modular $ 63.00 $ dwelling service or feeder (2) lob site address: 150S S 57th street City: Sprinqfield I State: OR I ZIP: Reference: I A 0 Z. 0 4 I 4 I Taxlot.: 0, 20 L/ DESCRIPTION OF WORK Wirina for nAW "inalA f"milv rp"inpn Services or feeders: installalion. alteration, relocation 200 wnps or less (2) $ 81.00 $ PROPERTY OWNER .. . 201 to 400 wnps (2) $ 95.00 $ Name: .T",mo" Sw"rt7.1"nnAr 40lto 600wnps (2) $158.00 $ Address: l,>ns S 57th street 6OItol,000llI)!1liW2) $205.00 $ City: Sorinafield I State: OR I ZIP: .~" e: ~~m-,.0Its(2) $469.00 $ Phone: - - I Fax: ..~t-ITION;.::~~ted 'I tint! ,U!~, $ 63.00 $ E-mail: to"OIH ':::-:: centel. ,~ ~ 'i......... feeders: installation, alteration, relocation This installation is being made on reSidentt.lIiI$~b\ai ~ooy ~,.;.\,,,,~ I $ 63,00 $ b.~ owned by me or a member of my immediatll I ina'f 0 ~ cMt .' "'"woo $ 87.00 $ property is not intended for sale. exchange,eeBll,.o ~e~Rtel. 1\,\01" ".t...AA\. 479.540(1) and 479.560(1). calling 1ltneOl 9 '1'>"li\l~s(2) $126.00 $ Signature: nllmbelc~ntel is <> Over 600 wnps or 1,000 volts, see services or feeders section above CONTRACTOR INSTALLATION Branch circuits: new, alteration, extensionper{X1nel Business name: Posi ti ve Enerqy Elec Cont a F~ f~! branch circuits with purchase ofaservice or feeder fee: - Address: qlin7 NR lith !':t-rp~t- Each branch circuit I $ 6.00 $ City: v" .r I State: WlI I ZIP: 9 8 6 6 4 b. Fee forbmnch circuits without purchase ofa service or teeder fee: Phone" <; (t u 81< ,>.. 4 4 7 q I Fax: 'h'O.. 'l ? h.. 1 Q 1 A . First branch circuit (2) $ 55.00 $ E-mail: 1. i ""-no,,i t-i VAAn I~~rn,..""t- net Each additional branch circuit $ 6.00 $ CCB license no,: 1 R S 7 R 8 I BCD license no.: r 4 A h Miscellaneous fees: service or feeder not included Signing supervisor's license no.: '-I?-J... ~ <-:> Each pump or irrigation circle (2) S 63.00 Print name of signing supervisor: tJ .... (-; ~ / v>v1A{ /"';. <: _I, Each sign or outline lighting (2) $ 63.00 S t f'. . - Il /)./ Signal circuit or a limiied-energy panel, igna ure 0 slgnmg supervisor: tII ..I J (/ .l~ alteration. or extension (2) $ 63.00 $ ~~ ' ~~~~~ (EAa)Cbaddi~i~~al inspectio;~:~ANT USE $58.00 $ ~ ~ ~~__ ~ve fees ~ c..: ~\. ~ ee $58.00) $ 217 ~. ~O~\\.~lf\ ~t.~ e ge(.12x[A]) $ 35.~ \\"\\S ?()~\1t.~ U~ ~ \s echnology Fee (5% of [A]) $ jll.8S 1>-1j\\"\Wlt.~Ct.~ ~t.~$j)~OTAL fees and surcharges (A through C): $ 347. l( 'I CQWI coO ~~ 1>-~'{ '\ $ $ 440.2584.) (9108ICOM) 2~ willamalane t~ Park and Recreation District Job. No. Q,\D. \~\ SYSTEM DEVELOPMENT CHARGE WORKSHEET Ja uary 1-June 30, 2010 NAME: PHONE: \oaa . toO\€) ADDRESS:~tITY~STATEQR:.ZIP~11 LOCATION OF PROPOSED BUILDING SITE: \5$<(1 s. ~\~ Street Address: Plat Name:~.'\l\e.uJ_ Tax Lot Number: \~O'2J):\\."'\ n\1,Cff 1. DEVELOPMENT TYPE (Check appropriate dwelling(s). Dwelling type definitions are on the back.) A. SinQle-Familv Detached NO. OF UNITS \ . X $2,858 per unit = $ f12fi!J.~ B. SinQle-Familv Attached NO. OF UNITS X $3,100 per unit =. $ C. Multi-Familv Apartment NO. OF UNITS X $2,641 per unit = $ D. SinQle Room Occupancy NO. OF UNITS X $1,321 per unit = $ E. Accessory DwellinQ Unit NO. OF UNITS X $1,550 per unit = $ $ !le68~ ~ WILLAMALANE SDC 2. SDC CREDIT (If applicabl~) SDC payer must furnish proof of Willamalane Credit approval.) $ 3. TOTAL WILLAMALANE NET SDC ASSESSED (if SDC reduced for Credit) . $ tflc6.cV 3. I !O/ZO~ Date Development Services City of Springfield 5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000219 Date: 03/10/2010 1:32:19PM Job/Journal Number COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM20 I 0-00 141 COM2010-00 141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM2010-00141 COM20 I 0-00 141 COM2010-00141 COM2010-00141 COM2010-0014! COM2010-00141 COM2010-00141 COM20 I 0-00 141 COM2010-00141 COM2010-00141 COM20 I 0-00 141 COM20 I 0-00 141 COM2010-00141 Payments: Type of Payment Check cReceintl Description Plan Review Residential Addressing Assignment Willamalane Single Family Temp Power 200 amps or less Fire SF Fee - Residential Plan Review Major - Planning Building Permit 2 Baths One or Two Family I st Appliance Vent Fan Exhaust Hoods Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Curbcut Permit Sidewalk Permit PW Disc _ 2nd Permit ''1' .J Overwidth Application Fee Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Tran Reimburs-Residential SDC Trans Improvement-Resident SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC MWMC Compliance Charge SDC Transportation Admin + 12% State Surcharge + 5% Technology Fee ,.:":.' ri Paid 8)' JAMES SWARTZLANDER Item Total: Check Number Authorization Received By Batch Number Number How Received 162 In Person Payment Total: DJB .;,;, ":(> ", i":" ~ w' ,. Page I of] Amount Due 71.43 38.00 2,858.00 63.00 138.95 211.00 1,225.64 337.00 79.00 45.00 13.00 134.00 100.00 88.00 88.00 (30.00) 45.00 1,338.55 666.84 507.07 211.21 931.65 101.97 1,333.57 10.00 176.08 22.63 80.09 239.60 119.93 $11,244.21 Amount Paid $11 ,244.21 $11,244.21 3/1 0/20 I 0