Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT -3 <br /> COMPUTE.R/PERMIT * rn ZGG� 11 <br /> SITUS/FACILITY ADDRESS: //7 S. <br /> DBA: /,V <br /> BU-LTO: — PHONE: Y6Y- y��i <br /> BILLING ADDRESS: 70 v £, <br /> CITY/STATE: S/v c l fv <br /> / C4 ZIP: <br /> PROGRAM: /ic, sT TYPE OF SERVICE <br /> THE VMlI MUM T ba FOR EACI INSPECTION IS ONE (1) HOUR, ANY ADDMONAL INSPECTION TIME IS COMPUTMD TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME <br /> d 3 c> D <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP'T'ION OF WORK REHS NAME <br /> 3AM- 430PM-SAM/ <br /> 430PM WEEKENDS <br /> DNl y 1 <br /> /w <br /> 3 3; Sr3tiS 1{ yr' � Pi <br /> TOTALS <br /> BALk�iNCE DUE- <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22(91) <br />