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.. .- ~[^>"~.: .. '~~.~ _ '. t..r'. .. - ._.. .. ~ ..: '';°'~:7.~.. +- !..7w+:.u~.~.s~6a•~f^asi.•'~M~~T`..~4:aa.:y,., <br />• ~ <br />• 1 <br />- 1 <br />~.,... .. ..r_.... ~ ,... .......,..., <br />` .•CITY OF LA PORTS <br />c - ~ ~ . <br />. ~ 8~ .' ~ESIDEN~':CA~. ~ :. <br />PE:~'ITIDN ~'OR E~CTENSIUN - . • <br />OF • <br />• WATER AND SEWER MAINS ' <br />. ~? ~ <br />XAME OF PERSON MAICINC REQUEST <br />.STREET ADDRESS `~L~`~____ J~~ ° , <br />• .LEGAL :DESCREPTIDN OF PR •_~._ <br />OPERTY , <br />• FEES ~ ; <br />WATER FRONT FOOT FEE° $1.44 per 120~sq. ft. ---- ,, • <br />. WATER TAP -.$184.00 _ ~ .. <br />TOTAL WATER <br />SEDER FRONT FT. FEE- $2.30 per IZO sq. ft. r'~~ <br />• SEWER TAP ' _'~~- ~f-~ <br />, $243.50 <br />. <br />:''OTAL SEFIER ~f ~~ --~ <br />• ~~T ~ ~ V <br />INSPECTION FEE, $5.75 ~~~.~ ~J~ ~. <br />COMBIP:ED TOTAL WATER AND SEF7ER. ~ ~ =~% <br />~ 7'"• <br />• . <br />APPROVED: <br />CITY EtJGINE.'•'R: <br />.~.. <br />CO,+fMISSIONER <br />., <br />• ' <br />r <br />Name of person a.king request <br />Date of request <br />Date of Pa ymen tea - ~ ~ ~ ~y~j <br />Receipt ncrmber_~• ~_~r-__ <br />Date completed <br /> <br />._ ~ -z <br /> <br />