HomeMy WebLinkAbout2174 CHESTNUT AVE; ; SE873081; PermitCASHIER'S VALIDATION
SEWER PERMIT APPLICATION
OCX)? 04/29 0101 04Sanitn 1000-00
APPLICANT TO FILL IN SHADED AREA SEWER PERMIT NUMBER : SE 306'/
BUILDING PLAN CHECK NUMBER:-. PC
', BUILDING TYPE:.
CALCULATIONS:.
'.. '„*<**,•*»• •••~.\
NUMBER OF EDU'S:
CONNECTION FEE
COST PER UNIT x NO. UNITS ' X»
LATERAL CHARGE:
TOTAL CHARGES:'._
PREPARED BY:
(PRINTED NAME)
COMMENTS: .
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WHITE; DPS GREEN: Finance CANARY: Water PINK: Building GOLD: Applicant