HomeMy WebLinkAboutPermit Building 2006-11-24
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: cOM2004-01290
ISSUED: 11/24/2004
APPLIED: 10/19/2004
EXPIRES: OS/24/2005
VALUE: $ 50,804.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2657 MAlA LP
ASSESSOR'S PARCEL NO.: 1703251407100
Springfield TYPE OF WORK: Manuf Home w
Garage/Carport Private
TYPE OF USE: Net\' Residential
REQUIRED PARKING
Overlay Dist: .. Mi!' 2
# Str~~ffi~~~qd: SHAll EXPIRE IF 1HE V\}!f: icapped:
PavediJj)iii8'tP1l~~\1 OER 1HIS )5{~MI1 \S<N.~ act:
% of~~~qOOageD UN ABA1~NEO fOR
COMMENCED OR IS
- .., rCDlf'1l1
~ ~l~~ -1. XIJ 01 ~ru ~
I PUBLIL llvlPR'O V J!.lvlENTS I
PROJECT DESCRIPTION: MH with garage
Owner:
Address:
CATHERINE PHILLIPS
2204 DONOVAN DR EUGENE ~ 074~n taw requires you to
AI u:.,m re.. I l' ~.._,;;......1 Itility
tonow rules aaopL~U uy "" c.f_I::/__ -
Notification ~RL4NF
In OAR 952 , f h lJ S bv
contra'll810 You may obtain caples 0 t e r ~reense
HARRIS0&1~5~~C (Note: the tel~~o1P.A~
ROBS EL~ Mt<the Oregon Utility Notiflf~lM
HARRISON JAC~ ~~80o-332-2344). 66447
I BUILDING INFORMATION I
Contractor Type
General
Electrical
Plumbing
# of Units:
Primary Occupancy Group: .
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
1
R-3
U-l
VN
# of Stories: 1
Height of Structure
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Electric
Energy Path: Path 1
Sprinkled Building: n/a
3
I DEVELOPMENT INFORMATION.
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
27.00
6.00
5.00
33.60
0.00
Street Improvements:
Storm Sewer Available:
Special Instruction:
Phone Number: 541-484-1326
Expiration Date
05/07/2005
08/14/2005
05/07/2005
Phone
541-689-7762
541-686-5444
541-689-7762
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
5,618
1,080
280
Fully Improved
Yes
Sidewalk Type:
Downspouts/Drains:
Curbside 5'
Curb and Gutter
Notes:
Pae:e 1 of 4
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Foundation Onlv . Use Bid Amount
Garae:e Garae:e
Manuf Home Manufactured Home
Fee Description' .
Plan Review Residential
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ Ea Add
Addressing Assignment
Garage/Carport
Manuf Home State Issuance
Manufactured Home Conn - Plmb
Manufactured Home Feeder.
Manufactured Home Placement
Manufactured Home Service
Plan Review Major -,Planning
Sanitary Sewer - 1st 50 Feet
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 Reimbursement '.
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Water Line-1st 50 Feet
WiIlamalane Manuf Home Private
Total Amount Paid'
" .
CITY OF SPRINGFIELD
Building/Combination Permit
. .
PERMIT NO: COM2004-01290
ISSUED: 11/24/2004
APPLIED: 10/19/2004.
EXPIRES: . OS/24/2005
VALUE: $ 50,804.00
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
$24.30
$1.00
Square Footage
or Bid Amount
4,000.00
. 280.00
. 40,000.00
Value
Date Calculated
Total Value of Project
$4,000.00
$6,804.00
$40,000.00
$50,804:00
10/19/2004
10/19/2004
11/05/2004
~
Amount Paid Date Paid Receipt Number
$74.88 10/19/04 . 1200400000000001486 .
$55.82 11/24/04 2200400000000001441
$39.07 11/24/04 2200400000000001441
$3.00 11124/04 2200400000000001441
$31.00 11124/04 2200400000000001441
$115.20 11/24/04 2200400000QOOOO1441
$30.00 . 11/24/04 220040000000000144i
$45.00 11124/04 . . 2200400000000001441'
$50.00 11/24/04 2200400000000001441
$160.00 11/24/04. .2200400000000001441
$50.00 11/24/04 . 2200400000000001441
$103.00 11/24/04 2200400000000001441
$45.00 11/24/04 . 2200400000000001441
$365.60 11/24/04 2200400000000001441 .
$480.80 11/24/04 2200400000000001441
$10.00 11/24/04 2200400000000001441
$865.31 11124/~4 2200400000000001441
$82.03 11124/04 2200400000000001441
$98.91 11/24/04 2200400000000001441
$66.65 11/24/04 2200400000000001441
$772.49 11/24/04 2200400000000001441
$175.13 l1/i4/04 2200400000000001441
$559.86 11/24/04 2200400000000001441
. $45.00 11/24/04 2200400000000001441
$45.00 11/24/04 2200400000000001441
$1,000.00 11/24/04 2200400000000001441
$5,368.75
'1 ' Plan Reviews I
..
. '. , "
Pae:e 2 of 4
Status ' Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line.
CITY OF SPRINGFIELD.
,: Building/Combination Permit
,PERMIT NO: COM2004-01290
. ISSUED: 11/24/2004 .
APPLIED: . 10/19/2004
EXPIRES: '05/24/2005
VALUE: $ 50,804.00
Initial Review
10/20/2004
10/2012004
WE LLH
Randy from Gooden Harrison called
and asked that we place this plan
review on hold pending the
financing of the home. He will call
to let me know whether or not to
proceed with plan review. If-we do
not, we can process an 80% refund
of the plan review fee he paid on
10/19/2004
Received call from Roger, okay to
process
Initial Review
11/05/2004
11105/2004
APP' LLH
Plannine: Review
Public Works Review
Structural Review
11/05/2004
11105/2004
11/05/2004
11/15/2004
11109/2004
11/23/2004
APP
APP
APP
TAJ
CAS
DLM
As per plans
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.
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction witbfooting and/or
foundation inspection.
Foundation: After forms are erected'but prior to concrete pl~cement.
Shear Wall Nailing: Before covering sheathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspeCtions have been approved.
Drywall: Prior to taping. .
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building. Inspector. .
Manuf Home Set Up: When installation of all piers or stands is complete.
Final MsnufHome Set Up: After all required inspections are requested and approved and porches, skirting,
decks, venting, street address numbers, trees, driveway, etc. have been installed.
Final Building: After all required inspections have been requested and approved and the building is complete.
Water Line: Prior to filling trench and including required testing. . .
Sanitary Sewer Lhie: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench. .
Manuf Home Plumbing: After home has been connected to water and sewer.
Rough Electric: Prior to Cover '
MH Electric: When blocking, setup and plumbing inspections have been approved and the home is connected to
the panel.
MH Service: Approval required prior to utility company energizing service.
Final Electric: When all electrical work is complete. .
Underfloor Drain: Prior to cover or placement of concrete.
. ,.
Pae:e 3 of 4
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2004-01290
ISSUED: 11/24/2004
. APPLIED: 10/19/2004
EXPIRES: OS/24/2005
VALUE: $ 50,804.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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 an work performed shan 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 an 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 an
times during construction.
u~
/ I- Z '( -() l/
Owner or Contractors Signature
Date
Pae:e 4 of 4
Sep-30-04 03:14P
P.02
t "3Al{J~J:1J\
m FIFTH STREET . SPRINGF IEW, OR 97477 " PH,(S4'j726.J753 · FAX, (541)726.3689 ,..~. .,:"
ELEl.:l.KICAL P.~AMID(\fffil~'ATION ~V\)~ '2>~ .,'\" .' .
\ I l 0-'2>'2> o..~\~0
City Job Number . l Date ;,,0(,' ~\. ~0
.,. .. 0~~'-0'2> "~
1. i\Or..'ATION OF fNSTAl.I.t\,TIOl,r ~ 3. COMPLETEJ.~!j!~DULE
rL.~ t\\ltl.n) ~\::{\'{\~~~ o~,{\~ .
L1~~;:r~qNA -7'\i -\0-0 ~ A. : N.~'Y R~.Si~t;;ltifl~~ sing~ or ~~~~nil)~ peT dwdling~nit .'
\' \U-~L;~r:r \_ll Service Included \)",,\'6 {\1-ftP S
M ~~~;~ON 1I'\M." .J Ii 1\ lie, f) ~~~~ :~d~i~~~t~;o sq. ~j~::
\ \ \UJ-\.U..! :\\~~ -, (1 ~ U portIon thereof
Per~its are non rra~sfer~ble and expire i~~~rk is \ Each W.unufne!'d :-lame ;)r
.' not starred within 180 d~)'s of iisuance or if work i> Moduiar Dwelling Service or
Suspeuded for 180 days. Feeder
S 106.00
$ 19.00
Q~
$50,00 .~
:',o<::::::~~~;:X~:~ X\Q B. ,;;~:::~o:~::'dWC [n,un.tio~ AIt"';~~:R'''''tloa'
- '-' I
\\ 201 Amps to 400 Amps $ 75.00
A~dress vC', h"Y< 2..P.:>2J 401 ^i~ to 600 Amps $12~,OO
601 lr\M ~~rU~N~lQ!egon law requlr8f1~o
City~~'(\~ ~cn~hone &:8bS8.~ o\'erf~~~~~.~r[OPted byffte ureg'J17~81ty
U Relz.IQtm~~~qn Center. Those rules aremMorth
I I '.1' \ I \ Q_ . J~ ()f\~ 9?2-oo1-001 0 throug~. OAR9S2~01~ . '..
Supervisor License Number '--+ '-\''-t':::> C. \,}P'l~.r~bIJ;fIi~dt4)btcli~COp>lesoftheiU.bY;" .......
\ calling the center. (Note: the telephone .
\ D. \ () \ D"\ Imt;\t;M~lf6rWlErOteub\l~mUy Notification
\ (0 200 Amps or lOanter is 1-80~2-234.4)i 50.00
Constr. Contr. Number -l-~ Ie) LO---- 201 Amps 10400 Amps $ 69.00
c::: J ) 401 Amps to 600 Amps S100,OO
Expiration Date l\ \ l\ () 5 ---
'-' j O~er ?vO Amps or 1000 Voh~ see "B" above.
D.:.'Brllnch 'Circuib .. .
Expiration Date
_Si~nalUre of Suoervising EIc~trician_..
New Alteration or EJ>tension Per Panel
One Circuit
Each ,o\dditi..:mul Circuit or with
Servict: or Feeder Permit
l
S 43.00
$ 3.00
E:,.W
-
6W""'N'~~f~v\ )eJ1illt"}S
Addres.l ~)'1 \SOODillf1\ OC'
City ~~Ph~":- '~4.\WlO
OWNER L'-'STALLA Tl 0;-':
,; :-. ..' .: '.. : ..1: . ,I' :~ ;:.~' .. . .. .' ,; ,.. .~: ;. ~'. '".:"
E. J\Us~e~.ap,equs (Sen"ic~/fe.eder not included) .-Each Installation ..
The installation is heing n18de on propeny I own which
is nor intended for sale, !c(l$<: or rent.
Pump ')r imprion
. Sign/OutJine Lighting
Limited Energy/Residential
Llmired Energy/Commercial
$ 50.00
S 50.00
$ 25.00
S 45.00
Inspection Request: 726-3769
.Minimum Eitctric Permit Inspection Fee is S45.00 + Surcharges
4.SLryJTO.T,4,1:'9FAnOiT' . . .'l~ 00
NOTICE:7% Stat~~'urc~~rge . - ~f ~l~!
THIS PERrW' SPfflI:t.trEKPlRE IF THE WORK t U .?il
AUTHORIZfi6JIHNDER THIS PERMIT IS NOT I if) · ~ t
COMMENCED OOJSr:A8(tf)l~a,f.m:',;=~1 hr.11il.\ppljc~lion !-03.doc
ANY 180 DAY PERIOD.
Owners Signature:
MANUFACTURED HOME LAND USE AGREEMENT
225 FIFTl-f STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
As required by the City of Springfield Development Code, I agree that with the approval of the attached
permits, one of the following manufactured homes will be placed at 2.1'D 5""7 ~~/~ ~
Springfield, Oregon, City Job Number f'M2P'7j, O/2.?~
~ Type I 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 to the performance standards required of single family dwellings constructed under the State
Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width with an enclosed floor area
of not less than 500 square feet, that has a nominal roof pitch of2 feet in height for each 12 feet in width
and that-has no bare metal siding or roofmg.
The manufactured home shall be placed on an excavated and back-filled foundation not to exceed 6
percent slope within 10 feet of the perimeter enclosure. The perimeter foundation wall surrounding the
home shall be constmcted of stone, brick or other masonry materials, and with no more than 24 inches of
the enclosing material exposed above grade.
I further agree to meet all land use and City Code requirements of the above mentioned parcel within 60
days of the date of Issuance of the manufactured home set up permit. These requirements may include, but
are not limited to the items listed below. Specific land use requirements regarding your parcel are noted on
your approved set up plans and/or permit and your partition approval if applicable:
. Street Trees
. Paving Driveway
. Minimum 32 square foot storage structure
. Completion of partition approval
· Removal of any existing structures as noted on your partition approval
. Signing and recording of any required partition, easement, improvement agreements, etc.
. Final lot grading
. City Sidewalk and curbcut installation
. Any outside agency approval as required i.e., Division of State Land approval.
By my signature below, I agree to complete the above mentioned land use requirements.
/<.
6L;<VL~
Contractor Signature
Date
Il-ZLt-o'-l
Date
erN OF SPRINGFIELD SYSTEMS DEVELOPMEN-P:\~RKSHEET
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPJ;:
NEW DWELLING UNITS
1. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S.F. x COST PER S.F. CHARGE
1 1806.00 $0.310 = I $559.86
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
1 IMPERVIOUS S.F. x \ COST PER S.F. I x 1 DISCOUNT RATE I
I 0.00 I $0.310 1 50%
ITEM t TOTAL - STORM DRAINAGE SDC , $559.86 ,
COM2004-0 1290
Catherine Phillips
2657 Maia Lp
1703241407100
BUILDING SIZE(SF:
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
1 NUMBER OF DFU's x
1 20
B. IMPROVEMENT COST:
-I NUMBER OF DFU's
1 20
COST PER DFU
$24.04
x
$18.28
ITEM 2 TOTAL ~ CITY SANITARY' SEWER SDC
= I
$846.40
3_ TRANSPORTATION
A. REIMBURSEMENT COST:
ADTTRIPRATE x
9.57
I NUMBER OF UNITS x
1 1
COST PER TRIP
$18.30
B. IMPROVEMENT COST:
1 ADT TRIP RATE . x NUMBER OF UNITS x
. I 9.57 1
COST PER TRIP
$80.72
$947.62
ITEM 3 TOTAL - TRANSPORTATION SDC
= I
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's x
1 1
ICOST PER FEU
1 $82.03
B. IMPROVEMENT COST:
INUMBER OF FEU's x COST PER FEU
I 1 $865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
$957.34
SUBTOTAL (ADD ITEMS t, 2, 3, & 4) = I
5_ ADMINISTRATIVE FEE:
1 SUBTOTAL x I ADM~ FEE RATE
1 $3,311.22 I 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$3,311.22
CHARGE
$165.56
Cheryl Slaymaker
11/9/2004
1360
LOT SIZE (SF):
DISCOUNT
$0.00 .
x NEW TRIP FACTOR
1.00
x INEW TRIP FACTOR
1 1.00
PREPARED BY
DATE
TOTAL SDC CHARGES
5674
r/)
~.
~
o
u
~
~
t-<
r/)
.......
o
~
$559.86
1]070
I
$480.80
]09]
$365.60
1092
. $175.13
1093
$772.49
1094
=
$82.03
]054
= I $865.31 1 ]055
i
I $0.00 11054
= I $10.00 1056
I
'1
98.91 ]079
$66.65 J 1078
=, $3,476,78.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUN ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BATHTUB 2 0 3 = 6
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER / MOP SINK 1 0 3 = 3
CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRlG /WATER STATION / ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
SHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
I SINK: SINGLE LAVATORY /RESIDENTIAL BAR 2 0 1 = 2
URINAL, STALL / WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 2 0 3 = 6
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 20
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4,63
$4 .40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE /1000 CREDIT RATE
$0.00 x $5.29
=,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE /1000 CREDIT RATE
$0.00 x $5.29
o
=
$0.00
TOTAL MWMC CREDIT
.225 Fifth Street
,.,,-,~,,;,. I' _, ...
Springfield, Oregon 97477
541-726-3759 Phone
,....~ty of Springfield Official Receipt .
/velopment Services Department
. Public Works Department
Job/Journal Number
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-0 1290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-0 1290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-01290
COM2004-0 1290
RECEIPT #:
2200400000000001441
Date: 11/24/2004
Description
Addressing Assignment
Willamalane 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
Plan Review Major - Planning
Garage/Carport
M'anufactured Home Placement
ManufHome State Issuance'
Sanitary Sewer - 1st 50 Feet
Water Line~' 1st 50 Feet
Storm Sewer - 1st 50 Feet
Manufactured Home Conn - Plrilb
+ 7% State Surcharge
+ 10% Administrative Fee'
Payments:
Type of Payment Paid By
CreditCard WILLIAM HARRISON
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 052501 In Person
Payment Total:
11/24/2004
Pag~ I of I
10:20:38AM
Amount Due
31.00
1,000.00
50.00
50.00
3.00
559.86
480.80
365.60
175.13
772.49
82.03
865.31
10.00
98.91
66.65
103.00
115.20
160.00
30.00
45.00
45.00
45.00
45.00
39.07
55.82
$5,293.87
Amount Paid
$5,293.87
$5,293.87