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~ P umb n.g Perm t.App cation
<br /> Appl. Reed:.
<br />
<br />ECTION
<br />
<br /> P umb ng Perm t App ication
<br />S dg erin .
<br />
<br />BI Plbg,
<br />Date: 5i00 P:M Date:
<br />
<br />Type of Perml
<br />
<br />p Rge.
<br />
<br />Plbg, h .Phone, ,
<br />
<br /> pl~ pl~ ........... ' ' % NO" TEM$ FEE NEA" TO?A
<br /> : ' T¥ .... :.': ' ,' = ' apl , i NT
<br /> OF RMIT '" '. ! " 0 C ' [. AMOU
<br /> Base. Price . .. ..... .?. :,.. ..... .... ...... . .... .... . ..... .
<br /> Residential , ', · ' ' , ~. ' '" ........ ,; ' ' ' ~ · ,',
<br /> NewCanstructlon(eechflxlure),..~. · ,., :;,. ~, ....... '' 'r ' '" ,::~,,,,,i, ~,,,, ' ......... '' ,,., , ..I5.00,
<br /> +'..;5.00 , '
<br /> A lerat oas (each tlxtul'e) ..... ' ........... . ....... :,...,
<br />
<br />.... W~lerLines , , .,, ;,.,,, .,',' ¥, , ' ' ' ~,',' ' ,,.. ....
<br />i' + Per Ihe'llrel 1go feel or Iracllee' Ihereof ...... ,..
<br />,, Sewsr Service,Lice · ..... ', ,:,,,:, ":' ,..,, · ' .,~, .... ' ' ...... · ~ ,
<br /> ~rvate-Sha bcchargedpcrl00 or fract On thereof ~ , · . ....... ,.:,,. .... ,, i'",,"",$15~0D "' '
<br /> Commerce .. . . . ' ' ' ·
<br /> ~ : N,e.w...conatructlon (each fixture) ....... ,
<br /> ,A terations (each fixture)
<br /> Lawn Sprinkling System .
<br />' Toand including each protective device .... .-,, ..x,. ....... ' ,, ,,; , · .... ', · ..... ,, ' " .5.0(~
<br />. ., .FEE ~, .
<br />'P ease. return comp eta app catren . · · SUBCHA'RGE .~Z'. '
<br />with the ind.cated fee. ' .......
<br />..... . , ......... ..
<br />
<br />· I agree
<br />' ' the Ordinances of Marion
<br /> rant that I comply with the provisions
<br />
<br />;pressly war-
<br />
<br />( ) I am a registered and lice~
<br />( )
<br />
<br />( ) The'work will be
<br />
<br />licensed Plumbing contractor.
<br />
<br />ocoupy
<br />
<br />SIGNATURE Bld~s. ,BOard l~,eg,. ~
<br />
<br />
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