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1200 Alright Rd -BC98-001157 (1998) (NEW INDUSTRIAL) SHELL ONLY (DOCUMENTSZONE CONTRACTOR ADDRESS — PHONE # -30-3-- / / LOCATION OWNER _ ADDRESS DATE ` 3`3 ? l PHONE # - ) dl 91-P76 PLUMBING CONTRACTOR ADDRESS PHONE # SUBDIVISION: PERMIT # 21-- LOT NO. JOB /266sJ CSC COSTS ( f , 1 d co SECTION: SQUARE FEET. '77 5V FEE $ MODEL: STATE NO. FEE $ ELECTRICAL CONTRACTOR FEE $ ADDRESS PHONE # MECHANICAL CONTRACTOR ADDRESS PHONE # MISCELLANEOUS CONTRACTOR ADDRESS SEPTIC TANK PERMIT NO. SOIL TEST REQUIREMENTS ( FINISHED FLOOR ELEVATION REQUIREMENTS ARCHITECTURAL APPROVAL DATE: FEE S OCCUPANCY CLASS: INSPECTIONS ITYPEDATEOKREJECTBY FEE $ ENERGY SECT. EPI: CERTIFICATE OF OCCUPANCY ISSUED # DATE: _ FINAL DATE G (4f4y/ CITY OF SANFORD, FLORIDA APPLICATION FOR BUILDING PERMIT b N 4J U b 0 4 a W O PERMIT ADDRESS /d20uA1bn'4— PS Total Contract Price of Job I I T I©& Describe Work rMFEJaL BLY4 D1F?1Q5-WP,46F— PERMIT NUMBER c Total Sq. Ft.so Type of Construction Flood Prone (YES) (NO) Number of Stories ( Number of Dwellings Zoning Occupancy: Residential Commercial / Industrial LEGAL DESCRIPTION (please attach printout from Seminole County) TAX I.D. NUMBER OWNER _ ADDRESS CITY TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY BONDING COMPANY ADDRESS CITY PHONE NUMBER 32-?-V,??O STATE VL ZIP STATE STATE ZIP ZIP ARCHITECT 14-16V, 14, bc&-V f S ADDRESS CITY STATE /7- ZIP MORTGAGE LENDER ADDRESS CITY STATE ZIP CONTRACTOR C J G/per 'CS.-, PHONE NUMBER ADDRESS At-rD-r-f v ST. LICENSE NUMBER C6C. O,-/-8q%Z- CITY STATE rL ZIP 2;? Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC. OWNER' S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR THE IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. ACCEPTANCE OF PERMIT IS VERIFICATION THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713. m p D n rt a Sig ture of Owner/Agent & Date Signature of Contractor & Date o 0 a n Llrs, r &.r no.., gnbert V DI4 I e cJ% H N Type or Print Owner/Agent Name Type o Print Contractor's Name t: K Z m 3 01 W 3 a/9q ro ignature of Notary & Date S' nature of Notary & Date Z Official Seal) Official Seal) KAREN W• AILLS of Ft Exp 11/1112000 oF FtC KAREN W. AILLS My Comm Exp. 11/11/2000 O 4 My Lom Q NOT0.R n Bonded By Service Ins c I 'on Pow c y Bonded BY Service Ins m PUfSUC No. CC600029 No. CC600029.14 70 ro A r I 0 I Personally wn l i Oche i sona0y 11 Other ID 0 a 3 oDate: ar- c; o Application ApprovY: b z A FEES: Building Radon Police Fire H Open Space 1 Road Impact . p lication a y •I H O O PERMIT VALIDATION: CHECK CASH DATE L BY 1-9 u a ORIGINAL ( BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) 0 0 Z a E I THIS APPLICATION USED FOR WORK VALUED. $2500.00 OR MORE CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE #: 407-302-1091 DATE: PERMIT #: I BUSINESS NAME: ADDRESS: PHONE NUMBER: ( ) PLANS REVIEW TENT PERMIT BURN PERMIT REINSPECTION TANK PERMIT FIRE SYSTEM AMOUNT $ /S,9. 0d COMMENTS: S9 4:f-7- Fees must be paid to Sanford Building Department, 300 N. Park Avenue, Sanford, Florida. Phone # 330-5656. Proof of payment must be made to Sanford Fire Prevention before any further services can take place. I certify that the above information is true and correct and that I will comply with all applicable codes and ordinances of the ' of SaW orida. San& rd Fire Prevention Applicants Signature f Certificate Of Occupancy Addendum Owner: Crankshaft Rebuilders Address: 1200 Albright Road Date: 4/27/98 Reason for Disapproval: none Conditional Agreement: Subject to the following; Remove debris from outfall structure and install skimmer per approved drawings. Seed/sod butfall swale - Contractor/owner to maintain. Mitered end section at outfall pipe to be reconstructed. Install street numbers on building per E-911 standards. Approved by Engineering Department subject to acceptable completion of the above deficiencies. F:\SHA_ENG\Engr-Fi les\CertOucp\crankshaft.co 0 CERTIFICATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION DATE OF C.O. STARTED: ADDRESS: CONTRACTOR:Vrl, Cm a CHECK BELOW TYPE OF C.O. Commercial Interior Remodel: , New Commercial: lNewIndustrial: / Lk-- S J New Single Family Residence:_ New Multiple Family Residence:_ New Apartments:_ The Building Dept. has prepared a certificate of occupancy for the above location and is requesting a final inspection by your department. After your inspection, please contact to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has been denied. Your prompt attention will be appreciated. Thank you. DISTRIBUTION LIST: Engineering: Fire Department._ Public Works:_ Utilities/Cross Connection:_ Zoning:— Sc^ CERTIFICATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION DATE OF C.O. STARTED: al om 7 ADDRESS: CONTRACTOR:, CHECK BELOW TYPE OF C.O. Commercial Interior Remodel: New Commercial: New Industrial: C - New Single Family Residence:_ New Multiple Family Residence:_ New Apartments:_ The Building Dept. has prepared a certificate of occupancy for the above location and is requesting a final inspection by your department. After your inspection, please contact to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has been denied. Your prompt attention will be appreciated. Thank you. DISTRIBUTION LIST: Engineering: Fire Department:_ Public Works: y/# Utilities/Cross Connection:_ Zoning:_ CERTIFICATE OF OCCUPANCY REQUEST FOR FINAL INSPECTION DATE OF C.O. STARTED: ADDRESS: (e'fx' CONTRACTORJ e. CHECK BELOW TYPE OF C.O. Commercial Interior Remodel: New Commercial: New Industrial: New Single Family Residence:_ New Multiple Family Residence:_ New Apartments:_ The Building Dept. has prepared a certificate of occupancy for the above location and is requesting a final inspection by your department. After your inspection, please contact to the Building Department to sign -off on the Certificate of Occupancy, or submit a certificate of occupancy addendum if it has been denied. Your prompt attention will be appreciated. Thank you. DISTRIBUTION LIST: Engineering: Fire Department: Public Works:_ Utilities/Cross Connection: Zoning:— Np ro Woe 1 V-e 7 (361 o Tt,- 0 Ljr,- Ili-'/ CITY OF SANFORD, FLORIDA APPLICATION FOR BUILDING PERMIT PERMIT ADDRESS G - PERMIT NUMBER lv ('0 vW4-otal Contract Price of Job R _ , Total Sq. Ft. C. F' Describe Work Type of Construction --1 Number of Stories L Occupancy: Residential a W 4J U O w W 0 Number of Dwellings J Zoning m4-" —Z . Commercial] Industrial'! LEGAL DESCRIPTION (please attach printout from Seminole County) TAX I.D. NUMBER OWNER _ ADDRESS CITY TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY BONDING COMPANY ADDRESS CITY PHONE NUMBER` Ir6%0 STATE ZIP STATE ZIP ADDRESS CITY STATE ZIP MORTGAGE LENDER ADDRESS CITY STATE ZIP z CONTRACTOR C S .{`t1 ` W PHONE NUMBER ADDRESS ZZ 0 i% - ST. LICENSE NUMBER, C9!o41P 72 CITY STATE ` ZIP 3z77f Application is hereby made to obtain a permit told he work and installations as indicated. I certify that no work or installation ha commenced prior to the issuance of a permit and that all work will be performed to e t standards of all laws regulating construction in this jurisdiction. I understand th t a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS, C. OWNER'S AFFIDAVIT: I certify that all the foregor i formation is accu ate and that all work will be done in compliance with all appbb e laws r u a n construction and zoning. A COPY OF THE RECORDE COPY OF HE OF COMME WILL BE POSTED ON THE JOB SITE WITH PERMIT NO LAJE1fTHAN S tEN 'DAYS T E PERMIT HAS BEEN ISSUED. FAILURE TO RECORD A OTIC COMME C MENT MAY RE L I YOU PAYING TWICE FOR THE IMPROVEMENTS TO YOUR PROP RTY. I YO NTEND TO:OBTAIN FI ANC ING, C0 LT WITH YOUR LENDER OR AN ATTORNEY BEF RE EC DIN YOUR NOTIC OF C ENCEMENT. NOTICE: In addition to the requ1 em nts o thi lb t there ma be d Tonal restrictions applicable to this p o erty that fo d in th p records of this.county, and there may be addi i nal permit_ed from o r go ernmental entities such as water management d ricts, stencies, o e al agencies. ACCEPTANCE OF PERMIT IS VERIFICATION NAT I WILZ/NOTIFY THE O INN R OF THE PROPERTY OF THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713. ..................... y ro Z v 7 p ro h o n Signature of Owner/Agent & Date 1 ature of Con ract or & Date 0 a En j/F//e/ z Type or Print Owner/Agent Name Ty or',Print Contractor's Name o x O O E ro o h Signature of Notary & Date Si - a Official Seal) ARLE140fA-RUA-A.L l' a a 3tO Z >+ Ll r O N O a (n a) 4J ,4 o a) Z w E-H NOTARY PUOI_IC, STATE OF FLORIDA MY COMMISSION # CC476424 EXPIRES. June 26, 1999 7 4/ : _ Application Approved BY: t, Date: — "b `/ ) FEES: Building, Rad n Police I Fir !i Open Space ils M Road Impact Application - PERMIT VALIDATION: CHECK CASH DATE BY ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) THIS APPLICATION USED FOR WORK VALUED $2500.00 OR MORE CITY OF SANFORD, FLORIDA APPLICATION FOR BUILDING PERMIT t + f "'fi:. , PERMIT NUMBERPERMITADDRESS f....-- •--` ' -j `6• f.-Total Contract Price of Job-_ / / ! lC' Total Sq. Ft. L3 Descrdbe;.Work .. . •:,. ntn.,t'a:. f .._. Type ofConstruction~5'''" `+ `` °`A'`''E Flood Prone (YES) Number of Stories Number of Dwellings % Zoning , Occupancy: Residential Commercial cry Industrial c. LEGAL DESCRIPTION (please attach printout from Seminole County) TAX I.D. NUMBER OWNER t :(!.1? _ t'` ` t ;. 1; 1• e^ .. PHONE NUMBER ADDRESS' CITY `' + " / STATE - ZIP Sel . 1 TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY STATE ZIP BONDING COMPANY ADDRESS CITY STATE ZIP r ARCH-- I-EGT Ji E'r11 d-:•.J { h ADDRESS CITY f) ;C,s/_ry STATE E(,_. ZIP MORTGAGE LENDER ADDRESS CITY STATE ZIP CONTRACTOR ; 4.d'7K; r_"43;;t pin..!:+ PHONE NUMBER 3 ADDRESS 2 a 1 A i v`Y /jx(ST. LICENSE NUMBER CITYQM cr," STATE %`' ZIPS rI Application is hereby made to obtainr"a permit to d 'the work and installat ons.as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and<that all work will'"be,.pe'rformed to meet standards of.all laws regulating construction in this jurisdictionJ'I understand th ti '`a separate permit must.be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS, MeC.OWNER' S AFFIDAVIT: I certify that all the foregoi.g formation is accu to and that all work will be done in compliance/with all applicalaws regulla in construction tt, andzoning. A COPY OF THE RECORDED+ COPY OF I OTIC E OF.COMME C MEN ILL BE POSTED ON THE JOB.,S'ITE WITH PERMITS! NO LATER THAN SEIVEN (`•TjDAYS WFTER4T t PERMIT HAS BEEN ISSUED FAILURE TO RECORD A'INOTICE CIF COMMENCEMENT MAY RESULT.,IN YOU PAYLNG TWICE FOR THE IMPROVEMENTS TO YOUR PROPERTY.1 I Y O ,INTEND TO OBTAIN`FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFERE RECO,DING YOUR NOTICE^,OF COMMENCEMENT NOTICE: In addition to the requirements 0 this permit there mad be/yadd'tional restrictions applicable to this `roperty that jmay be fo rid in thApu J 1-- ecordsof this county;. and there may be additional permits requ ed from othier overnmental 11 r. entities sucli, as water management di stricbs,state! agencies, o j;ede`al agencies.,, ACCEPTANCE OF PERMIT IS VERIFICATION \THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713. 3 ro z ro n 0 o a a Signature of. Owner/Agent & Date i ature of Contractor'& Date o a K z U Type or Print Owner/Agent Name Type or Print Contractor's Name o x 3 0 N O ( 6 h7 a Signature of Notary & Date ti Signature of Notary & Date P. p (Official Seal) is aSea - Ic ARLENE K. R BLEY \ NOTARY PUBLIC, STATE OF FLORIDA MY COMMISSION # CC476424 4 C EXPIRES: June 26, 1999 a 3 '" o °nA Application Approved BY: T } Date: / b ` L1 a,,v< vs, . !. O Z..<.. FEES: Building Rad n Police %/' Fire H Open Space I\1 Road` Impact Application MD. (1_ U) M . w ;. N o 0' PERMIT VALIDATION: CHECK CASH DATE BY ro a o a) ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) z a F THIS APPLICATION USED FOR WORK VALUED $2500.00 OR MORE CITY OF SANFORD, FLORIDA APPLICATION FOR BUILDING PERMIT PERMIT.ADDRESS AJ A PERMIT NUMBER Total Contract Price of Job Total Sq. Ft. Descf,ib,O'Work, Type of Construction Flood Prone (YE,S) ;('N 0 :O. Number of Stories Numberer P f Dwellings Zoningfi Occupancy: Residential Commercial *_1 Industrial LEGAL DESCRIPTION (please attach printout from Seminole County) TAX I.D. NUMBER OWNER PHONE NUMBER ADDRESS CITY STATE zip e 7 TITLE HOLDER (IF OTHER THAN OWNER) ADDRESS CITY STATE ZIP BONDING COMPANY ADDRESS CITY STATE ZIP ZH A R ID", ADDRESS CITY STATE ZIP MORTGAGE LENDER ADDRESS CITY STATE ZIP 4 CONTRACTOR PHONE NUMBER ADDRESS ZZ96 10:,4,r1iA-4 t`Vx r ST.i LICENSE NUMBER C 4/ 7 t, CITY STATE ZIP I;os - :,as,--4` Application is hereby made to obtain*a permit to d C`'the work and installations indicated: I certify that no work or installation has commenced prior to the issuance, of a permit and,,that all work viillobe,r'performed to meet standards of all laws regulating construction in - this jurisdiction ,.,X I understand that,a separate permit must be secured for ELECTRICAL, PLUMBING, MECHANICAL, SIGNS, POOLS,,, TjC. iOWNER'S AFFIDAVIT: I certify that all the f.oregol2g,information is accu/ate and that leallworkwillbedoneincomplianceallappllicab)e,laws re Utati_;n I (Qonstructioh M T., WILL -BE POSTEDandzoning. A COPY OF THE RECORDED COPY OF HE NjOTI61E/ OF COMMEN ETN ON THE JOB,.SITE WITH PERMITS, NO LATER'tTHAN SE%YEN '(';7-r,,PAYS AiF-TER\TH,E PERMIT HAS BEE14 ISSUED .,'"'FAILURE TO RECORD A;NbTICE OF COMMENCEMENT MAY RE S " Tx,I& YOU PAYING TWICE"'FOR PROPERTY. IMPROVEMENTS TO YOUR PROPERTYILYOUNTEND TO'OBTAINF LFINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE -,OF COMMENCEMENT. 4` n,'addition NOTICE: to the requi rembnts of this permit (there maj, bePaddl.tional to this that in thd'\pu<b,lit records of restrictionsapplicable ..erty gma,y-,b_e,fo%.nd pp'r 0 V re ffi,qovlernmental thiscounty,",and there may be add itibnal permits qfai,±ed from Ot. - T' ieUetal agencies.., entitiessuch"i1.Sas water management,dstrlcts tate;Agencieg, 62 y 1\ 1- 1 ACCEPTANCE OF PERMIT IS VERIFICATION THAT I WILLANOTIFY THE OWNER OF THE PROPERTY' OF THE REQUIREMENTSi OF FLORIDA LIEN LAW, FS713. 0 Z 7- 1< M 0 10 " rt D (n 01 0 of Contra Date eaturetor & Date Signature ofOwner/Agent & c 0 n loco Z U Type or Print Owner/Agent Name Type or Print Contractor's Name D 0 0 4 0 Signature of Notary & Date Signature of Notar--y,& i7a 1 Official Seal) __0_,f_ f Ic W. is' 05aM, BLEY toll MJA Lj_11L_ - r" PU BLIC, UBLIC, STATE OFFLORIDA I My COMMISSION # CC476424 EXPIRESe JUR 26, 1999 k— BY Approved : Zj" ApplicationDate: lyFEES: Building RadonPolicelF —Fire Open Space Road Impact Application 1 r. 0 PERMIT VALIDATION: CHECK CASH DATE BY u 4J a0 4) ORIGINAL (BUILDING) YELLOW (--CU§TOMER) PINK (COUNTY TAX OFFICE) GOLD (CO. ADMIN) 4 Z 04 E- 4 H ME THIS APPLICATION USED FOR WORK VALUED $2500.00 OR,MARE MEMORANDUM February 20, 1998 TO: Building Department PJA FROM: Engineering & Planning Department ENGINEERIN BJE SUBJECT.- Building Perrnit Issuance Engineering & Planning Department acknowledges approval of attached development plan for: Crankshaft Rebuilders Parcel I.D. 34 - 19 - 30 - 501 - 0000 - 00A1 Received: Febnla 998 Address: 1200 Albriglit Rd., Sanford, Fl and concur with Building Permit Isl ce. Sile Plan approval by P Date,APP 5-W-ci 4 g p iistrative Official J O other Land Development Coordinator Erg. Plan approval by City Manager Dat prov 7i D other Prof ssional Engineer Condition of Approval: i. All construction must meet all City of Sanford Codes and Land Development Regulations. 2. All other permits required for this proicct must be obtained. 3. Owner to provide continual maintenance of existing fire lane road. Please provide a letter to this affect. 4. The City has not and is not permitting (With the attached plans) the existing driveway to Bevicr Rd. The existing unlawfiil connection does not constitute current nor future connection rights to Bcvier Rd. nor the Future Airport Avenue. The applicant must apply for a driveway permit frorn the jurisdictional agency if an official connection is requested. If and when the driveway connection is requested, the applicant must submit to the City of Sanford for review and approval, proposed improvements to the driveway (required to meet City standards), traffic and parking circulation information, and elimination of the double frontage access points. 5. Double Detector Check Valve assembly to be located adjacent to the ROW of Albrighht Road. yr(_.i., Chris Smith C:\N,Iyriles\WPWIN\WPDOCS\ENGCOMME\1200AIbiigbi..bidg CALL SUPvSt-HKEy 1-800-432.4770 ITS THE LAW IN FLORIDA rf i PROPOSAL AND CONTRACT I' a 2290 West Airport Boulevard Sanford, Florida 32771 k Phone: (407) 323-1150 Fax: (407) 323-9304 t CONSTRUCTION CO. GENERAL CONTRACTORSORS f 9. The building is to be constructed with a monolithic slab -on -grade and an eave height of 12'-0 with a roof pitch of 1: 12. 10. Roof to be a 26-gage galvalume "R" panel roof. Wall panels will be the manufacturers' standard 26-gage "R" panel (owner to select the color). 11. Install two (2) 3070 hollow metal personnel doors, and two (2) 12'-0 x 12'-0 overhead coiling doors. Hollow metal doors and overhead doors to be shop primed only. FINISHES 12. Exposed structural steel in the warehouse area to have a shop applied primer. GENERAL CONDIT'IONS- 13. Architectural Drawing allowance is included ($ 1,250.00). 14. Site Engineering Drawing allowance is included ($ 2,800.00). 15. Supervision and clean up as needed. 16. Testing of soil compaction, concrete will be provided. 17. Erection certificate for the metal building will be provided. 18. Builders Risk Insurance by owner (Owner must provide Contractor with copy of policy). Total for the above $ 119,106.00 14.89 Cost per Syft ouulect to ine terms ano conoltions set out herein and on the reverse hereof, the payment schedule, all of which are a part of this offer, McKee Construction Co., (Seller) proposes to furnish products and services as outlined above. McKee Construction Co. ACCEPTE PURCHASER ACCEPTE c., Title PRESIDENT MANAGER Date __t, ,%2 Date Since 1973 DEVELOPMENT FEE WORKSHEET CITY OF SANFORD UTILITY - ADMIN. P. 0. BOX 1788 SANFORD, FL 32772-1788 Project Name: C//K,Sit}F/ ,J 'iLd-,4S Date: //1 O Owner/C tact; Person: (jas'7/ V"^1 Phone: Address: l G Z P/';'69 % 1 6, Type of Development: 1) RESIDENTIAL Type of Units (single family or multi -family): Total Number of Units: Type of Utility Connection individual connections or central water meter & common sewer tap): Water Meter Size (3/4", 1", 2", etc.): REMARKS: 2) NON-RESIDENTIAL Type of Units (commercial, industrial, etc.): Total Number of Buildings: Number of Fixture Units each building): Type of Utility Connection individual connections or central water meter & common sewer tap): Water Meter Size (3/4" 1", 2", etc.) REMARKS: CONNECTION FEE CALCULATION: C vr}v7 ro(v! VC -V' V-29 PL yo 47 Name - Signature - Date e _ ,"2 //1 ? 1 3 REVISED 12/23/97