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4 r wq �_ l <br /> y <br /> fp <br /> HL <br /> A <br /> f <br /> 16 41 E. Hazelt-i_iy, Ave. , P,�4 X53,>. 2009 y._ PAYMENT <br /> ::t-ocrk:i.on, CA 9520 w RECEIVED <br /> 5 <br /> fls i K ,F`t1tT f, V. f H1t '#f 5 FEB (] �J � <br /> ENVIRONMENTAL HEALTH <br /> TlKdLl2 PERMIT/SERVICES <br /> HOR' I-#+"aN TI,.I L���N RES!1PT lji..} i„i;eIi4,`; <br /> 129 8"- MC Di_NAI D RD. 12°08- ii. i f.: L]O ALL] RD. <br /> ti1i ► ct• t.ei�oerrt. Ir��=r 1' ,a rrr, •t-,. .11 �i �r°�a��;_ wld 1 n6: F i1it•• , <br /> ,�;.-��-etsreiit• �icr i-� ) ti!ciilR.i�]�! 1 , 1_ <br /> 'ctYfre"r r t: x.)Ge i►s te: <br /> Fac -1 l.1 i-y Fc-e 14){_).047 <br /> ���=:;"s�.�:ll�� t�i.,t(iol+>=t•i 4;]r;r� l 5i.i.t.3iJ <br /> TOTAL FEE,,:. DUE r 1.`_-0_1'.10 <br /> Healt-h District- of a)3"y <br /> necessary Your- per`r i t. will <br /> he ffla .led Upon receipt. i,f <br /> payment. and appToval ol <br /> IniiIit•}' . <br /> F-N_.' -urn !^'C1yliic.-'€ft• wit-'! <br /> ENVIR{=NMENTA;L HEALTH PIE RN,I 1.1,3,EIRVIL:F:; <br /> P.c!. Lic!x `20 9 <br /> Pena 1 t-i e5 w?11 be addeQif <br /> .s. t-e s'� , <br /> 30 if ays 10(]% of Base Fee <br /> t � <br />