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WORKSHEET FOR POOL COMBINATION PERMIT APPLICATION
W. 4
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PLEASE PRINT OR TYPE BUILDING DIVISION
1. PROJECT ADDRESS (NOT MauNG nOORFss)
LOT
2. DESCRIPTION OF WO K 63 w
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ESTIMATED $ VALUATION 1�
SWIMMING POOL [t, SPA El,-
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;E USE ONLY
PERMIT NO.
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1—M
PLAN CHECK NO.
POOL P/C FEE $
DRAINAGE P/C FEE $
Forms\Pool spa apPI (rev3-04).x15
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