HomeMy WebLinkAboutOC_366832 - MiscCOUNTY OF ORANGE ENVIRONMENTAL MANAGEMENT AGENCY
CENTRAL OFFICE, REGULA'RION r -- "�OMIONAL OFFICE
P.O. BOX 4046 - .26052 GETTY DRIVE
400 CIVIC CENTER DRIVE WEST FEE RECEIPT. FORM - ILA13UNA NIGUEL, CA 92677
SANTA ANA, CA 927 2 714-631-26,10
714-834-2626
RECEIVED OF
ADDRESS: _ CITY �G
JOB OWNER:—
OWNER'S ADDRESS:
LOCAL PARK FEE REQUIRED FOR:
F.SINGLE FAMILY DWELLING DUPLEX
E. MULTI -FAMILY DWELLING
UNITS WITH BEDROOMS
MOBILEHOME PARK WITH PADS (Sites)
CENSUS TRACT AP
LOCAL PARK FEES DETERMINED OR MODIFIED BY:
DATE
JOB ADDRESS -Pi0 ,& �
.OR TRACT NO.: X �,p .moi
_ s�".
RECEIPT FOR
AMOUNT
TRUST FUND
(Check No.)
PLAN CHECK FEE
(TYPe)
GRADING PRE -INSPECTION FEE
LOCAL PARK FEE
ADDN:ALTERATION TO
t�� FERMITJ._
(Type) (Number)
'OTHER
0•
EJOTHER
-REFER TO a
BUILDING: �J
PERMIT BY
(Number)
1 OF026'79 366,832 20.00+ 2
INSPECTOR 1
TELLER DATE
F0250 -189.2(R 1178)
5� VERIFIED
- (ION s}
20.00* ,
��rr�Ca 2 0Isar
FEE `U 4
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