HomeMy WebLinkAboutPermit Building 2004-4-26 (2)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
e
_: CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00355
ISSUED: 04/26/2004
APPLIED: 03/31/2004
EXPIRES: 10/26/2004
VALUE: $ 247,962.00
SITE ADDRESS: 3325 Falcon Dr
ASSESSOR'S PARCEL NO.: 1702193406100
Springfield TYPE OF WORK: Single Family Residence
PROJECT DESCRIPTION: SFR - ambleside lot 95
TYPE OF USE:
Owner: RIVER V ALLEY BUILDERS INC
Address: PO BOX 2041 CORVALLIS OR 97339
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
RIVER VALLEY BUILDERS INC
G & E ELECTRIC INC
MIDWAY, MECHANICAL INC
MIDWAY PLUMBING INC
License
134566
54468
154166
4687
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constructiou Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
.street Improvemeuts:
1
R-3
U-l
VN
3
18.00
5.00
5.00
15.00
0.00
I BUILDING INFORMATION I
# of Stories: 2
Height of Structure 29.00
Type of Heat: Forced Air Gas
Water Type: Gas
Range Type: Gas
Energy Path: Patb 1
I DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
New
Residential
Expiration Date
04/15/2005
09/1512007
01130/2005
07/25/2004
Phone
541-367-1618
541-967-7045
541-928-2423
541-928-7927
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
1,740
780
622
2
REQUIRED PARKING
Total: 2
Handicapped:
Compact:
Yes
45.00
Sidewalk Type:
Curbside 5'
To Storm Sewer
Fully Improved
Storm Sewer Available: Yes Downspoutsillrains:
Special Instruction: See attached 1/fE!tl'YtJpJltiis for Sanitary and Storm Sewer connections.
regon laIN reQUI on Utility ,
Notesj>.\TEN110N:~pted bY the ore~re set lor' NOTICE:
lollolN r,u\e~~l\ter.lhOse ru~e~AR 95'2-00
'iotilicatlon _oo,\_oowthrO~g sol the rules. THIS PERMIT SHALL EXPIRE IFTHE WORK'
In OAR 95'2 obtain cople telephOne AUTHORIZED UNDER THIS PERMIT IS NOT
0090. :OUt~:~enter: .lNoteu\~~~ Notitication COMMENCED OR IS ABANDONED FOR
calling the oregon ?,,~~t ANY 180 DAY PERIOD.
number lor . _ " ~,~~ "",,,. Pa2e 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
V Wood Frame
Garaee
Dwellines
Garaee
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
3 Baths One & Two Family
Addressing Assignment
Annexed 1997
Building Permit
Curbcut Permit
Dryer Vent
Exhaust Hoods
Furnace - up to 100,000 btu
Gas Fireplace
Gas Outlets 1-4
Heat Pump
PW Mult Disc - 2nd Permit
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursemeut
SDC Sanitary/Storm Admin
SDC Transpo Admiu
SDC Transpo Improvement
SDC Transpo Reimbursement
Sidewalk Permit
Storm Drainage Impervious Area
Temp Power 200 amps or less
Vent Fan
Willamalane Single Family
Total Amount Paid
Initial Review
04/01/2004
e
. Lil t OF ;:)rKll~GFIELD
Building/Combination Permit
PERMIT NO: COM2004-00355
ISSUED: 04/26/2004
APPLIED: 03/31/2004
EXPIRES: 10/26/2004
VALUE: '$ 247,962.00
I Valuation Descrintion ,
$ Per Sq Ft
or multiplier
$92.40
$24.30
Square Footage
or Bid Amount
2,520.00
622.00
Value
Date Calculated
$232,848.00
$15,114.60
$247,962,60
03/31/2004
03/31/2004
Total Value of Project
FpP~, tIiIIJ
Amount Paid
$680.32
$10.00
$306.00
$31.00
$-20.52
$1,046.65
$75.00
$6.00
$9.00
$12.00
$15.00
$4.00
$12.00
$-30.00
$447.46
$588.64
$10.00
$214.23
$314.63
$120.37
$52.49
$727.42
$164.89
$75.00
$1,010.36
$50.00
$24.00
$1,000.00
$6,955.94 '
Date Paid
Receipt Number
3131/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
4/26/04
2200400000000000304
3200400000000000057
3200400000000000057
3200400000000000065
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
, 3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
3200400000000000057
I Plan Reviews I
04/01/2004
APP LLH
Paee 2 of4
..
-
. CITY OF SrKll~u.H]!;LJJ
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-00355
ISSUED: 04/26/2004
APPLIED: 03/31/2004
EXPIRES: 10/26/2004
VALUE: $ 247,962.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspectiou Line
Plan nine Review
04/01/2004
04/1712004
APP TAJ
Miuimum side setbacks require
survey.
Public Works Review
Structural Review
04/01/2004
04/01/2004
04/09/2004
04/13/2004
APP
APP
VRJ
RJB
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.
I )?pnn;rpt! Tn.,nprt.ilwiJ
I Curbcut - Standard: After forms are erected but prior to placement of concrete.
2 Sidewalk - Curbside: After forms are erected but prior to placement of concrete.
27 Rough Mecbanical: Prior to Cover
28 Final Mecbanical: When all mechauical work is complete.
29 Temporary Electric: Approval required prior to Utility Company energizing pole.
3 Erosion/Grading Inspection: After all erosion measures are in place.
4 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Post and Beam: Prior to Door insulation or deckiug.
8 Floor Insulation: Prior to decking.
9 Sbear Wall Nailing: Before covering sbeatbing witb finish materials.
10 Framing Inspection: Prior to cover and after all rougb In inspectiuns bave been approved.
11 Wall Insulation: Prior to cover.
12 Ceiling Insulation: Prior to cover.
13 Drywall: Prior tu taping.
14 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
IS Final Building: After all required inspections bave been requested and approved and the building is complete.
16 UnderDoor Plumbing: Prior to insulation or decking.
17 UnderDoor Drain: Prior to cover or placement of concrete.
18 Rougb Plumbing: Prior to cover and including required testing.
19 Water Line: Prior 'to filling trencb and including required testing.
20 Sanitary Sewer Line: Prior to mling trencb aud including required testing.
21 Storm Sewer Line: Prior to filling trencb.
22 Final Plumbing: Wben all plumbing work is complete.
23 UnderDoor Mechanical. Prior to insulation or decking and including required testing.
24 UnderDoor Gas: After line Is iustalled and required testing and capped if not attacbed tu an appliance.
25 ,Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
26 Gas Service: Mter line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at tbis point.
Paee30f4
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 wurk 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 ou 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 J'err card is loc at the front of the property, and the approved set of plans will remain on the site at all
~~/rruction.
Owne~0,..6ontractors s(gnatur~
<
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
e
Pa2e40f4
e CITY OF ~rlUl~u1<IELD
Building/Combination Permit
PERMIT NO: COM2004-00355
ISSUED: 04/26/2004
APPLIED: 03/31/2004
EXPIRES: 10/26/2004
VALUE: $ 247,962.00
4-7~ -04
Date
(
SPR..,NGF"..ELD, ~,' :,'=11
~~~~~
225 FIFfH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3751lh: fo~n&5Jr!lJ6\lj;~~,\\jlmitte~~ol~~:~~~
ELECTRICAL PERMIT APPliCATION zoning, and does not require spec;I;c!landfuse -
City Job Number CCM1 ZLl 0 '-{ - 00 -S ~ Date approval. LbrC.
_ _w ,.~ .
1. ~LbCATloNoF,~n.lsr;'riJtTIO' -N'-i-."0,:;;:-;,"_ti n~::;;-~~r7'~."'X1-T~'-='t"'7.~...:.~~I""':~~~~~~~'-;r':="'..".71
~ ..' . '~~'7)~,,-;....,c-!C'~",,"4"~ 3, ~~S2:&~~i!~~~S:~~B1.~g~Q~~~.;~\", ~~j
, '32z <7 .;::;; k ,p"", ~c- , Authorized Signaturo
LEGAL DESCRIPTION A. ~,~~;~~~;'1i;;r~~~I~g~~%fifi~~ifi,:~&"~~wm~,'~,;!:r.~ii1f2lj
.'.<ll:.Az--;4.::iJ-~;k.;;x.. ,~..:,.~tj;""",~':;;J~_~':;1l;;'~'~"'.A,.j~~,'%,l~(~~;;;;<;'''~~''''~~
j 7{) Z. 193 L( oGIO 0 Service Included
. ..~,;,..,>: H'crtY,dF:'5~.~qNGF~LP; OREOQ~::':" 'U ':":~
. , ' ". - - -~ -. . -..., - -, .'
,CW\~
e.i';<.-/ c-<'L..
1000 sq, ft, or less
Each additional 500 sq, ft, or
portion thereof
$106,00
JOB DESCRIPTION
$ 19,00
Permits are non-transferable and expire if work is Each Manufact'd Home or
not started within 180 days of issuance or if work is Modular Dwelling Service or $5000
Suspended for 180 days. :Oreoon law reqUires ;Ji..ee~~' '
_,_'AT:t"lllT.IP~__, ~O n~' '
t,~eoNiRA,~"~er">,,..,t&s~14}~i~'TI([jM<m1!Y~.1 reg~. ,~~ er.,\,>:i.Z~~~~j.tcF~1i~~~:ih~t~'li~'fi~ri1~AI,t~Viti~;~t\.,~:R~ici~d~:' ;"f1
,2. hn"e'."",' ''''-:j;~T~~f~t~..tCJ:'&f\l'eS :~e q ~:~.~'" ,_..,~\1!"I.Ul""'~,.''''':'''''~, ~~.,"'.,"~tJ
ElecnicaI CO!llrnctorn nAR QS2-001-0010 through 0 h 't66 Amps or less $ 63.00
, bt COP't:lS of t e ru1eS",
0090 You may 0 aln 201 Amps to 400 Amps $ 75,00
, t r (Note' the telep!lon,,'
Address r.allino the cen e ' . ":'''t Notit18.1.ws to 600 Amps $125,00
, number for the, u~e~~~' ~~~IX",Il), 601 Amps to 1000 Amps $163,00
City Phone /. Over 1000 AmpsNolts $375,00
( Reconnect Only $ 50,00
\' J:-' !i:;""-' *".""',,"''>0'+' ._~ -_.' "~>~."~"';'oi\li;~',.ogJ"~~U''''
Supervisor License Number ~ \5 ' Co ,,:r~'*por!LrY$~&!~~;!!~-,l'~e,i!eQ',"'~~'r[\"E~~~~i'W\
Expiration Date \)~ Ah" Installation, Alteration or Relocation c-0
\ r/i~ /ICt. 200 Amps or Ie~s '/ $ 50,00 ~
Constr, Contr, Num'r AU" 'S PFlf,i 201 Amps to 400 Amps $ 69,00
CO~/'fORI1/ir S/il/ 401 Amps to 600 Amps $100,00
A4'" ~F4IC O/l/va II E,fBj~ 600 Amps or 1000 Volts see "B" above.
180 ^ 1:0 Db 'ER r."Z~ ~/~i:f;lf~ifl/~<;';iil';'ri.,~'\'€ll,~f,i,;!~~";;:'X1>i'EJ",'",;].,1
Signature of Supervising E1ecnician vl/y pf.'l IS 1/0.'1#/;'8, '(Ji;:.f!lt-~.f4'l'Wi., _,.,;rr~~~~~~:i!ID"'/ "'''''',
RIOD. 'I/~N~~~W{};yfr"tension Per Panel
One'~'f.b. AlOr $43,00
Each Additl~aI Circuit or with
Expiration Date
Owners Nam6i--~ f.-.,o.../ \:'; VI
Addr?):f,O{ Box 704/
Ciri Ov"VQ J J:~, Phone 7 26 -()5~O
Service or Feeder Permit
$ 3,00
E.lIW~~ill*~~~ri~'~~~ed~_~4e.~~iL~(ri~4):t#l~l{~~1~_l4~t~~~-"
OWNER INSTALLATION
Pump or irrigation
Sign/Outline Lighting
Limited EnergyIResidentia1
Limited Energy/Commercial
$ 50.00
$ 50,00
$ 25,00
$ 45,00
The installation is being made on Y'V ..;/ lawn which
is not intend d for sale, lease or 1.:
Minimum Electric Permit Inspection Fee is $45,00 + Surcharges
<:/ CLnature( ~
"'---'" ~ -
lnspec . n Request: 726-3769
~
~\:<r~"T~;-_~'.'C/'~\::}":7i:1f ..j.~.-;:;to'~1 ';:r,~:~, ;':',-f..~:~.....-{jl;k:f~";i:;t.l.t::: '~';~r.,:i;
4, 'SUBTOTAL OFABOVE ,,",,',.',"'0' ""'~'WC"
,lc<4~~~""'P!:;;-~"~Jc~'.t"w _"'_~-__<<- :,''''c!~.'';~l.:i::::_-;~\.j1
7% State Surcbarge
10% Administrative Fee
SO'
::>fV
:>,,0
t s8?
TOTAL
I
Shared Drive(T:)/Building Forms/Electrical Permit Application 1-D3.doc
CITY OF StNGFIELD SYSTEMS DEVELOPMENloRKSHEET
JOURNAL OR JOB NUMBER: Com2004-00355
NAME OR COMPANY: River Valley Builders
LOCATION: 3325 Falcon Drive
TAX LOT NUMBER: 17021934 t16100
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 1 BUILDING SIZE (SF' 0 LOT SIZE (SF):
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F, x I COST PER S,F, I I CHARGE
I 3484,00 I $0,290 I = $1,010,36
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 DISCOUNT
I 0,00 I $0,290 I 50% I ~ I $0,00
ITEM 1 TOTAL - STORM DRAINAGE SDC
2, SANITARY SEWER - CITY
$1,010.36
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x I
I 26 I
I
COST PER DFU
$22,64
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 26 I
COST PER DFU
$17,21
ITEM 2 TOTAL - CITY SANITARY SEWER SDC =,
1, TRANSPORTATION
$1,036.10
A, REIMBURSEMENT COST:
I ADTTRIPRATE I x I NUMBER OF UNITS I x I
I 9,57 I I I I
x I
COST PER TRIP
$17,23
x INEWTRlPFACTORI
I 1.00
B. IMPROVEMENT COST:
I ADTTRIPRATE I x I NUMBER OF UNITS I
I 9,57 I I I
ITEM 3 TOTAL - TRANSPORTATION SDC
COST PER TRIP
$76,01
5892,31
x INEWTRlPFACTORI
1.00
= ,
4, SANITARY SEWER - MWMC
A, REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 1 I $314,63
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I I I $214,23
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
~ I
5518,34
5225
51,010,36
5588,64
$447,46
$164.89
5727.42
=
5314,63
ilf2
10
10
I~
~
CIl
G
~
111070
~
1091
1092
, 1093
1094
11054
I
1055
1054
1056
SUBTOTAL (ADD ITEMS I, 2, 3, & 4)
53,457.11
5, ADMINISTRATIVE FEE:
!SUBTOTAL I x I ADM,FEERATE 1=
I $3.457,11 I I 5% I
TOTAL SANITARY ADMINISTR,ATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
CHARGE
$172.86
Virginia Jurasevich
PREPARED BY
4/9/2004
TOTAL SDC CHARGES
DATE
=
5214,23
(520.52)
510,00
=
120,37
$52.49
$3,629.97
1079
1078
e
e
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x: UNIT EQUIVALENT - DRAINAGE FIXTURE UNITS
(NOTE, FOR REMODELS. CAlCULATE ONLY THE NET ADDITIONAL AXTURES)
NO, OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
IBAftiJUB - 1 0 3 3
=
IDRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC, 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 '2 = 0
ICLOTHESW ASHER / MOP SINK 1 0 3 = 3
ICLOTHESW ASHER - 3 OR MORE (EAl 0 0 6 = 0
IMOBILE HOME PARK TRAP P PER TRAILER) 0 0 12 = 0
IRECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0
IRECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0
ISHOWER, SINGLE STALL 2 0 2 = 4
SHOWER, GANG q-<UMBER OF HEADS) 0 0 2 = 0
SINK: COMMERC1AURESIDENTIAL KITCHEN 1 0 3 = 3
SINK: COMMERCIAL BAR 0 0 2 = 0
IS1NK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2
ISINK: SINGLE LAVATORYIRESIDENTIAL BAR 2 0 1 = 2
IURINAL, STALL/WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 3 0 3 = 9
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 26
.EDU (Equivalent DweJlinp; Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
----
I
I
L-
MWMC CREDIT CALCULA TION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDITRATE/$I,OOO I
ASSESSED V AWE
55,04
55,04
$4.95
S4.88
$4,75
$4.58
$4,41
$4.20
$3,88
$3,50
$3,07
$2.60
$2.14
$1.71
$1.52
$1.38
S1.l9
$1.03
$0,87
$0,68
$0,46
$0,27
$0,09
50,04
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enler 1 for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX, CREDIT?
(Enler I for Yes, 2 for No)
BASE YEAR
1997
CREDIT FOR LAND (IF APPLICABLE)
V AWE / 1000 CREDIT RATE
$30, I 8 x $0,68
~ ,
$20,52
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
V AWE / 1000 CREDIT RATE
$0,00 x $0,68
TOTAL MWMC CREDIT
$20,52
=
I
I
:!
1
i'
I
I
-.J
o
o
, . " .
225 Fifth Street
Springfield, Oregon 97477
,541-726-3759 Phone
-
~
Wir:
_ of Springfield Official Receipt
"elopment Services Department
Public Works Department
Job/Journal Number
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
"COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM2004-00355
COM20Q4-00355
"
COM2004-00355
RECEIPT #:
2200400000000000408
Date: 04/26/2004
Description
Plan Review - Planning
Building Pennit
Addressing Assignment
WilIamalane Single Family
3 Baths One & Two Family
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
-Mechanical Issuance Fee-
Gas Fireplace
Heat Pump
Temp Power 200 amps or less
+ 7% State Surcharge
+ 10% Administrative Fee
Sidewalk Pennit
Curbcut Pennit
Stonn 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/Stonn Admin
SDC Transpo Admin
Annexed 1979 or Before
PW Mult Disc - 2nd Pennit
Payments:
Type of Payment Paid By
CreditCard RIVER V ALLEY BUILDERS
Item Total:
Check Number Authorization
Received By Batcb Number Number How Received
IIh 00365 161479 In Person
Payment Total:
',j
4/26/2004
Page I of I
12:39:30PM
Amount Due
71.00
1,046.65
31.00
1,000,00
306,00
12,00
24,00
9.00
6,00
4,00
\0,00
15,00
12,00
50,00
\03.93
148,47
75,00
75.00
1,0 \0,36
588.64
447.46
164.89
727.42
314.63
214,23
10,00
120.37
52.49
(20,52)
(30,00)
$6,599.02
Amount Paid
$6,599,02
$6,599.02