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INTERGOVERNMENTAL PERMIT REQUEST <br />PUBLIC WORKS DEPARTMENT <br />PERMIT FEE WORK SHEET <br />Permit Number <br />Project Name <br />ACTIVITY GL <br />Ciearing-Machine <br />Concrete/Rockery Wall <br />Cut/Bore Street <br />Drainage System <br />Driveway <br />Erosion Control <br />Grade/Fill/Excavate <br />Misc: & Fences <br />Parking Lot Paving <br />Plan Review <br />Site Inspection <br />Mitigation Fee: <br />Traffic <br />Other <br />BN <br />J4 <br />BL <br />J6 <br />B8 <br />BM <br />BP <br />BK <br />BJ <br />BD <br />BE <br />BT <br />�'i�ta ��C�.gS� - �%�1 <br />ACCOUNT NUMBER <br />002-322-4013-831 <br />002-322-4015-831 <br />002-322-4012-831 <br />340-368-2001-000 <br />002-322-4011-831 <br />002-345-8311-831 <br />002-322-4018-831 <br />002-322-4017-831 <br />002-322-4014-831 <br />002-345-8312-831 <br />002-322-4016-831 <br />157-345-8601-000 <br />School Mitigation: Receipt from district required prior to <br />permit issuance Amount <br />Accounts to be charged: <br />Authorization <br />PW Fees.xls <br />FEE <br />�� r'� r� r� <br />Date <br />