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HomeMy WebLinkAbout135 CHINQUAPIN AVE; ; SE862908; Permit(Citg of CASHIER'S VALIDATION SEWER PERMIT APPLICATION APPLICANT TO FILL IN SHADED AREA BUILDING ADDRESS: / 3£^&WA/{$fM/%frt / ^•p""***1 OWNPR. &S9&*3%Z*/ JjJZ./J&ejft? {**)/ \ **f *"~) \ A $ MAILING ADDRESS: fTO „-**> S/ /i^lT±D >/ViT)J J/\' ' "~.--" -.-»„,,,»,,.. : .. CONTRACTOR: MAILING ADDRESS: LEGAI DESCRIPTION- /3^€&L / sS^/fe^ty *? ' • • • f • ' - • •'•'-. •„ : . ASSESSORS PARCEL NUMBER: COMMENTS: .. SEWER PERMIT NUMBER: SE *£~S&C3 BUILDING PLAN CHECK NUMBER: PC GO "~" 3&i / BUILDING TYPE: ^r~Z^ '• NUMBER OF EDU'S: /. Cs CALCULATIONS: / S/^ =• / j£Z%/ ,' CONNECTION FEE COST PER UNIT /^ a2CsOf~~~ x NO. UNITS /• fJ.f \ - j>g> v LATERAL CHARGE: . fe? SLs . ^/s^n®*-TOTAL CHARGES: / /> fe> v'CX PREPARED BY: -^//sT) / />//"/£?*/ (PRINTED NAME) »«/ WHITE: DPS GREEN: Finance CANARY: Water PINK: Building GOLD: Applicant