Laserfiche WebLink
_ . .. . <br /> �; <br /> APPLICRTION FOR <br /> �i�'���f o���� lOsechanical Pe�rt <br /> GENER]►L ZN'r'ORMAT20': <br /> I. /N Y/til�I { <br /> a� .atw�•ul !��••t♦ ►� ••1l •� .• Nu�. ai i�e t�tf �IF+iu• ►�•It1•t� ►u�.l• s�t �.�jul A A� <br /> p�lala a�t a��Itipf H�♦ •�r.r ��1�+. <br /> � t[C 7�L A'►Lk�1TtGtD.••�tf Mufi,r0~[G1MtY�TII le( sltrlt�C�RO�IS+►PS110�0�vTMl )0/�SIT(.ARI �01 �A1J0 Y�ill YOY <br /> J. Y►a���/�er e�uta�cti�■ �a a�u1a(.•f u t..�l.�/, • �iH�t� ►.illi�3 Iat.:t wsl 1� •rl�:+af. <br /> I. ,�wa� r�l �a 4�t i��sc��t�ua.at� Sqla �.:!/:w� C�I� �a�.a+c�•p. <br /> 3. AtL wd �+�t �t :.�Iact�I I��N�-:• ••I (1..L1. C�LL I1J•7JS1 71-�0.+ ullsa ���a1��(. <br /> 1. 1b.�a Mtat:y tt�t teu�I�.�1 ►a �.Matl�/ ►�(��� (:•�� • ��t •ll•eA�f. <br /> INSTRUCTIONS ��•►t�c� �f[ •u.• •• u.� �►s�+t�t��.. [�.v.1a [w� ►�+••� (t�. ty� �.s I�t• i�< <tsu{���t.��. <br /> IYCO�/llf[ Al►U MTIOr1 ri:l Hi /[ I�OCIlf[/. I{ Y�� ��r� ••��li�+�r a�l� I1J-7Jfl <br /> WALK-IN PERNITS AppGy a.t Ct.ty o66�ce:, 1335 Sou.th B�own Road (Cty. Rd. Jfb) <br /> FiAI1-IN PERWItS Encloet 6ee - ►ta<C .to: P.O. Boz 66, Crtye.tcC Bay, Nrt. 55323 <br /> •������������������a���s�������r���a�s�ss���r���y�tss�����s��y������s����s�ss�• " <br /> � G�4sc.o T '� � a�;' <br /> JOB SITE 3�2 � <br /> Ota�N�a/ f�►ai a�(I��ii.l ��c�r�tat�l� Ouia ..���L!��. <br /> Owner's Name Telephone Number � ,�.,��;� <br /> �,'; <br /> Mailinq Address —� �t� <br /> G�;y ln�r"��t�.;= Telephone Nuiaber ��/'� '�'� <br /> Contractor's Name �I�f N � ,C L` - "r.;` <br /> r J �P �p �c.5. M�/. ��= <br /> Mnilinq Address L l.� � � � <br /> •�tttf*w����w�ww�w�wwt*��wwwr*w*w*w�*+Rw�w**w s*w�*f*w»wsswtffwsw*�i►wwrs�f*sltf <br /> �I1111Mat/Lt If7o.00 qr pro�.cal <br /> ......................................................• � <br /> •.���u�•.•�••...••....••..•.••..•••••.•....••..•.•.••........ $2 O.00A�cA uwlt <br /> IWTi11G iTfTtKS <br /> � n�t. ���. �_lv 1u. �_oti. __d�cc. <br /> o�r f�p�el[y il ca.Eiwctow Durn�r) <br /> tQyit. {l�n+n tAun 1 Ynit p�r D109•, ll�t ��cn ��p�r�ulr) <br /> �s �ftt ���n r�a�+c �.na w..� noe.1 Mo. <br /> t. •. tura�o� <br /> Iw Du13.r • <br /> w�lc M�ur <br /> �o►�r ncv• $SU.U�K�y�. soul <br /> pulp+,nt ..........0.............................�uu..����. , <br /> .�u��.�.........•..........•................................•...... �, <br /> �0•QQ ��e� w�lt <br /> �CONDSTIOMSNG r <br /> C�acr•1 Alr �frpar�t� Centr�l Alr fynw <br /> — �/Wrn�e� T�t�l <br /> •r�nd M�r Nod�l Mo. Sbn� . .... . .... ..... .... .............•.......•.. <br /> .•. •••••••••••••••••••• ••S�V.�7U•��cA unit ••Mood•ltow rlaA l2w <br /> •�-�•�•••IN� nuve+�•l�u�eA oopY•o[•�l�s'• inac�li�clon sP�a�•l• $50_� �uA wlc �wod oo�iw�clon or�dd-a��fc <br /> /�cwry Ilnpl�u(�l Y I����sud1M �Oullt-ln � ��eA wis �Kwry [lnpl�a�vftA !1w <br /> wool acov�l�) y � `�ru�rlin, c:n.. 30' <br /> �ruN Iiw �K..�3G� Mod�l Mo.�, 7ot�1 � <br /> ut�t'� Ml�. Cl��r�wcu. �11� s��r . N...�r.w.D...�•.0....... . .... .... ...•.......••. ..•. •.•••••••..•••o <br /> .�••.................•.�....••• •�•5.00 ucA �wluwt lu�a IWtA. i1wM�. <br /> vr�I�rL �tcla. •ca.) <br /> yo. �1cltcMn LaWwt duct�0 ndreul�clnq �al� <br /> �p. �Ncp Lstwu�t (�u�t W duet�d o�t�id�) _�t� <br /> a!� 'n+ul __ <br /> �Ip�.�OtM.•r.°�...•.�.�•.....�..........�.....�.�.�• •..r�..........�..•...........r.•.........•.�..��...��...•.�����• <br /> a2Y1�r! l�wt W �pPror�d py tls� �+raMll ' . <br /> �r►wl 011. ��pllon� �_�d•rqrouud��ia�ld� �outsld� <br /> _sa ws. _v1ioa. <br /> _ocA�c. ................... -. <br /> ................................................................ Y <br /> .......................................� a) Fasiuen[ial 520.00 <br /> �*�«*• �*t� ($20.00 minimum; $100.00 maxiawm) b) Commercial $20.00 Plan Aeviev <br /> pu�G��ot M�+d��_ Mo. ot Ri��cs � <br /> Toul <br /> rn.o[ �r.e.. c7 ..c. oc vi.,.. rw....a..•...............g2'00 per�head................................ <br /> ................................................ .. <br /> tc�aral�l, Indwtsl�l c w+ici-r..t1y ,« r•• scn.aul. <br /> PERMIT FEE CALCULATION � <br /> 1. Total of above Installations or Minimum Fee (%20.00) S <br /> 2. State Surcharge ��< <►• s�.0 s�ua.,a c.�� o.�....+ sw��.w• c. �.�� r�*�c S .50 ,;.' <br /> ', �;.. <br /> 3, Postaqe and Handli^7 0. .[c ...ca�-t+ •vv<«•«•+•• �d� �`� ►°•c.�a `"i ►.+u.•� i•• S 1 00 � , <br /> 3 <br /> ^ adQ li.[• 1-3 abrs $ ., �,.� .����� <br /> 4. TOTAL PERMIT FEE ' ��,,' <br /> T�a r./a��i�.ad Y�aa►Y �silie� t• :4t facy •� O�ou {o♦ i��ua+cc o{ a �acYuiea[ Ii�.[t. •gaia♦ 1• d• atl rr�k i� �t+iU • �.;�•:: <br /> �cu4��•ca r.iM Ut ���•+��cu •� t�e C(tY a./ lLe ♦t�ulatio.• �( tMc �a.�c�ata Statc t�.itl<.a Calt. a�Q ta+ta{as� t�at „Y�;.i <br /> a(� �qta•t�u .��t �• aMi� ayP�acati�• aat c�.YLuc. twa �.d u+uU. , <br /> .�¢ .l,�!,. <br /> �� <br /> i�u <br /> avvt�aca"��— aaei <br /> �� � . <br /> � �� �4c,�� �� ;_ �+����� � ��� �� yp�aa°{ �� . <br /> � , -� . , �w ae � �� t �F �d�`+�k,,'F"�a�)''��^,.r5�'�� ��'#�°`��� ° r � �,, <br /> .� ,. <br /> , <br /> . <br /> .�s.��. ,��k. ..,�.. .e�t. r�ra,�;:,. ,.t.. ...;n , =.>v ,'ts � ...� ,� k . <br /> � <br /> . . : . :: .. 9 ,.�: <br /> ;jaz''�'� r����'�,�t�d'k � `9�r� Fi,���� p�G��a� ;.,, +*�''��,,an7"�,t'�rMy�',�� ��`�,s.. ��'t�'�ih`i�'�. �c,. �:j�x� " � 21 <br /> .a` , , �':k" . .� '� . . .*�`�" . ''.�-,�9� ..,.r .,2,^��9..�r �a �. , - . <br />