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FOR OFFICE USE ONLY PERMIT #M.� 2[ k 1) -CC <br />PUBLIC. WORKS <br />FEES :: _:... <br />INTAKE: Checked By: Date: <br />Comments: <br />High Hazard Sites (Dental/Medical, Animals, Mortua etc -Review for RPBA) <br />❑ Public Works / Sys Dev / Traffic Mit. / P A - NOT REQUIRED <br />❑ Route for Public Works Review (bid Ider, PW Worksheet) <br />❑ Public Works Permit -Concurrent Revi (separate green folder) <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Plumbing Fee <br />Mechanical Fee <br />Ping Bldg Review Fee <br />PW REVIEW: PW Reviewer: Date: <br />❑ PW Permit Approved - PW _ <br />[]See PW Review Works e <br />❑ PW Permit Not Req I <br />Water Fee <br />Sewer Fee <br />Systems Dev. Fee <br />P . ,DEPART- MENT <br />Update/New Sprin rYes <br />_ No_ Existing Bldg._ <br />Update/ New Det ction No _ Existing Bldg. _ <br />Update/ Ne Chemical No_ Existing Bldg. _ <br />Update/ ew Fire Service No Existing Bldg. _ <br />Date: <br />Comments: <br />