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COST' ESTI�'�'IATE FUR PERNlI"1' FN:r; CALCULA"17l �N <br />Date: <br />�-. <br />/�1. ;> ' U> <br />Public WorksPemiitNo. Pd�lUS�d_��� <br />PROJEC7' NANIE: .�.� 3� I 1.=, i'1= I e �v ti} }-� r..-�,�1 � _ <br />LOCATION: �i `�Xi� L7� �i V l.� S�%. _ <br />DL:'VELOPER: Li.'_vn�i�`l ���ELcr'���tit` i �v� -- <br />Name: ��`i �iZv f..� I n! <br />Address: 'j%�a `11 <,t ��� I�,� <br />) P� �— � ' <br />Cit �/Statc/Zi V ,__��' �l^ ��1�� �� ! '?< � � <br />Telcphonc: =�_' ` ^ -��' ��� `� `' = � -- <br />CONTACT: <br />Namc: � >__ ��' ' � --- <br />Address: <br />City/Statc/"1_ip: __ _ <br />'1'elephone: <br />Asphalt Yaving ( Sq. ft) <br />Total of Public Improvcments <br />Total of Privale Improvements <br />rERnnT r� �: <br />Porofficc ux onl�� <br />Asphalt 1'a��ing <br />Plan Re•�iew Fec <br />Inspection Pcc <br />Perfonnance Guarantce <br />(1 � X ca9 of Public Imp�o�nmrnts) <br />"I'OTAL <br />�. . � ..7 � �..� ,...�— <br />r-• �J i <br />'--t� i.�' <br />� 7� . � J �3 <br />�� , : ? 'i� <br />$ I-� . <br />� <br />� <br />� <br />1/� <br />