HomeMy WebLinkAboutOC_898 Halyard- MiscCOUNTY OF ORANGE ENVIRON'
CENTRAL OFFICE
P.O. 1REGU,6ATION
ENTAL MANAGEMENT AGENCY
BCX 4048 ..;
400 CIVIC CENTER DRIVE WEST
REGIONAL OFFICE
26052 REGIO DRIVE �
SANTA ANA, CA 92702
" 714-834-2626
FEE RECEIPT FORM
LAGUNA NIGUEL, CA 92677
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LOCAL PARK FEE REQUIRED FOR:
nSINGLE FAMILY DWELLING
FIMULTI-FAMILY DWELLING
UNITS WITH
nMOBILEHOME PARK WITH
0 DUPLEX
BEDROOMS
PADS (Sites)
CENSUS TRACT AP
LOCAL PARK FEES DETERMINED OR MODIFIED BY:
OCT 15'RC
TELLER DATE
F0250-189.3 (R 3/80)
DATE
RECEIPT FOR AMOUNT
TRUST FUND
(Check No.)
PLAN CHECK FEE
(Type)
GRADING PRE -INSPECTION FEE
ElLOCAL PARK FEE
ADDN.-A ER TION TO
c
PERMIT
( Pe) (Number)
OTHER
11( 1 OTR
0
BUILDING
PERMIT -
384,026 15.00+ z
INSPECTORI
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VERIFIED
D f.
BY:
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(InBials)
15.00
FEE