HomeMy WebLinkAbout1315 BASSWOOD AVE; ; SE1987; PermitCASHIER’S VALIDATION
:WER PERMIT APPLICATION
4PPLICANT TO FILL IN SHADED AREA
MAILING ADDRESS: S#&K
CONTRACTOR: oL/d/cl&-
MAILING ADDRESS:
ASSESSORS PARCEL NUMBER: -~~~‘/70 -or
SEWER PERMIT NUMBER: SE
BUILDING PLAN CHECK NUMBER: Pc 6 7-
BUILDING TYPE:
NUMBER OF EDU’S: -5
CALCULATIONS: ,/ 1
/
CONNECTION FEE
00 I 60 s‘ COST PER UNIT - x NO. UNITS= [m
LATERAL CHARGE: €XI3
TOTAL CHARGES:
PREPARED BY:
COMMENTS:
WHITE: DPS GREEN: Finance CANARY: Water PINK: Building GOLD: Applicant
CASHIERS VALIDATION 1
SEWER PERMIT APPLICATION
4PPLICANT TO FILL IN SHADED AREA SEWER PERMIT NUMBER: SE
BUILDING PLAN CHECK NUMBER: Pc ,' i'-
BUILDING TYPE:
NUMBER OF EDU'S: i
CALCULATIONS:
CONNECTION FEE
j 2,qq - ~ x NO. UNITS .. COST PER UNIT
LATERAL CHARGE: .6 p
- TOTAL CHARGES: '. 2,
PREPARED BY: 1' ; 1 (PRiNTED NAME)
COMMENTS:
WHITE: DPS GREEN: Finance CANARY: Water PINK Building GOLD Appllcant
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