Laserfiche WebLink
ENVIRONMENTAL HEALTH_A.CCOUNTING DIVISION <br /> UN _5 <br /> IT # WORKSHEET <br /> CO MPUTER/PERMIT jo <br /> SITUS/FACILITY ADDRESS; <br /> DBA: C - <br /> ` <br /> BILL TO: 5 r, <br /> BILLING ADDRESS: 4, 3/ <br /> CITY/STATE: /'"U Ile, <br /> P R O G RAMI: �,rC,T f'r� ZIP: f'S <br /> ---��TYPE OF SERVICE:,-- <br /> THZTHS MINIMUM ME FOR <br /> "ST UM EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME I5 <br /> (1/2) HOUR, INCLUDING TRAVEL ME. <br /> COMPUTED TO THE <br /> DATE WEEKDAY <br /> of WEEKNIGHT HOLIDAYS DESCRIPTION S30P 4:30P:�1-3A jW IPTION OF`WORK RENS NAME <br /> SERVICE 4:30P:rI Vil"EEKENDS <br /> ; � � /'Y1 Vic' r SrIY �dC•at �/ <br /> IV <br /> 2i+Yr — �'//Y �. <br /> TOTALS <br /> I3ALANCE UUF- <br /> BILLING DATE: <br /> i <br /> EH 23 074 (Rev 3/91) <br />