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Planning & Bul ing Agency <br />Building Safety Division <br />20 Civic Center Plaza <br />P.O. Box 1988 (M-19) <br />Santa Ana, CA 92702 <br />(714) 647-5800 <br />www.santa-ana.org <br />PROJECT ADDRESS: <br />PERMIT NO.: SC �S,� qq <br />n <br />LJ <br />FEDERAL CLEAN WATER <br />PROTECTION ACT <br />SUITE# <br />BY: ' <br />PAID BY� 1Q )CICC 1 ��r��'t` 3 ►r VC,- , DATE: <br />Effective January 1, 2003, a surcharge is being added to the cost of site plan review, building, <br />grading and plumbing permits to pay for the obligations associated with the new federal <br />requirements. The program is administered by the City of Santa Ana Public Works Agency. <br />Questions and appeals may be directed to PWA by calling 714-647-5074. <br />Site Plan Review <br />Building Permit <br />Plumbing Permit <br />Grading Permit <br />Receipt # 4956 <br />05717002 53617 $ <br />05717002 53621 $ <br />05717002 53622 $ <br />05717003 53623 $ <br />TOTAL $ L. I X'K'Z <br />Validation <br />PLink/W P51/Forms!#81 9-2011 <br />