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P umb t~g Perm tApp ~ Plumbing Permit Application
<br />
<br />Bldg. Permit~ No.
<br />
<br />By:
<br />
<br />Type of Permit:
<br />
<br />Tax Lot No:
<br />Sec, Twnshp, · Rge.
<br />
<br />Plbg. Installer ' .Phone
<br />
<br />' ' ' ..... FEE ON EACH
<br />TYPE OF PERM T / NO OF TEM$ ' 'TOTAL AMOUNT
<br />Base Price .... ~ ............. ' ..... $10.00
<br />, ' , New Construction (each fixture):/' ; :,., ,, , - ' , ", ........... ', . ,, v._~
<br />'i~'""AlteraUbns(aaChfixture). ,',, ' ' ,.,; .... ' , ' ' '!:,,;. r',,,~,, ,'~ .... ~,-5.00 ,,
<br />,, Water, Lines, ,, , ,_, ...... , ........... , ...... · , -,,,,-,,, ,, , v,, , ~ ,,-, ,,, ,
<br />............ $15.00 ' '
<br />Fo~the first,lO0 fe~?r fraction thereof ~., . , .. , ,~;, · ~ ' '
<br />; ,, Sewer, Service, Line , ', ' '
<br />Prvate. Sha bechargedperlO0 orfractonthereof , ~ · , ", ',. < < $15.00
<br />, Commercial ,,. ,,; , ............. ,~. ,....,,,.. ,:,.,~,., ......., . , ,,, , , ,, ,'
<br />- NeWcqnatruct!qe{each fixtuye) ., ..... , · '.:,: ..... ,. , ...... , ' ~,, , . '., . ,5~00' ,. '
<br />.... ' A teratloss (each f xture) · ............... ~ ...........
<br />· , · : ..... ',,,,'i ,: ,' ' ' .5.00'
<br />:' Lawn;SpHnkllng,S, ystem ,' . .,' ........ , : , .. ' · , , , . ,
<br />~,~,i~,~o"ar~d.jncl,',cllrtg'~achlJr6tectige.da~b', ',',,', ,,, ...., ,.,,,:.,, :;' '.,, ;.'~? :,,~, ',~ ....
<br />, "' , ' 5.00
<br />/ , ' ' .., : · , ,, ~, ;, .FEE '' ' . ,
<br />Please return com eta aDD Cat on - ~
<br />w th the indicated ~ee: .
<br />.... TOTAL · ,
<br />
<br />~rdlng
<br />
<br />urzner expressly
<br />
<br />~dd '
<br />
<br />licensed
<br />
<br />Umbl'~g ~on'['ractor.
<br />
<br />
<br />
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