Laserfiche WebLink
C0S'1' ES'1'1MA'1'E t'UR FERN H' k'EE CALL ULA'1'10.N <br />Date: <br />Public Works Permit No. <br />PROJECT NAME: <br />LOCATION:_ <br />DEVELOPER: <br />Name: <br />Address: R) A4 <br />City/State/Zip: Ev R m �j k <br />Telephone:' <br />CONTACT: <br />Name: A <br />Address:15 <br />City/State/Zip: ,~^ <br />Telephone: 4,3C-" — <br />Asphalt Paving ( Sq. ft) <br />Total of Public Improvements $ ' <br />840 <br />Total of Private Improvements $ B-Q4D_ <br />PERMIT FEE: <br />For office use only <br />Asphalt Paving <br />Plan Review Fee <br />Inspection Fee <br />Performance Guarantee <br />(1.2 X cost of Public Improvements) <br />TOTAL <br />$ ®::q '� 6.22- <br />$ 2e <br />