Laserfiche WebLink
ti. <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# <br /> COMPUTER/PERMIT # 6 6 G1/,* 36- <br /> SITUS/FACILITY <br /> 6SITUS/FACILITY ADDRESS. l��QL� A/t AcT 9J`�3� <br /> DBA: _ <br /> BILL TO: �f�1"IL.tJ PHONE: <br /> BILLING ADDRESS: J1 � Il� �T/j IC/Ir� �Wi I«y ✓(7[ <br /> CITY/STATE: 11 ✓V\O a � � Z^IP: n <br /> PROGRAM: V / TYPE OF SERVICE: � � G K ATTIC (�° W <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITION INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. 31415 <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> -3a � <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />