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TI'T FEE ETI <br />I~1EILI VAIlE ITE ~JNIT ~~JII;[~y4 U E L~4~~y ~I-~//i'' I~ I l i~ U T 1 I E <br />F * oo iL■ i~JJVN T., 1~4 <br />~ ..r,+~ ~T~II~, VIA 7-l{!V i + f~ Q <br />rri~+i+**~r ~HEf ~.l~~oOi <br />~ FAQ: 71 7-~7 FOi' ff~~~ I~~~ X11: <br />~r~~~ <br />P~7BLI ~ F II~T~I Fl <br />1~~r u~~ ~ ~uhli~ ag~n~i~s that have contra~t~d with ~ eontra~tor on a publ~~ words pr~jet r~ul~t~d ~ <br />1 7Foo t~ 7.7oa in com~li~n~e with R 7.8. Also for use b public a~~ne~~s that ~r~ a <br />party to a public w~rl~ pro~~ct pursuant #o ~I 7.SOO6~a~B or <br />PU~LI I~EIVIE: l~lea~ arn~~t~ ~n~ t~~il t~~ ~o BALI at the above address} along with the public <br />v~orl~s fee ~ one-tenth ~f one p~r~ent of the a~tra~t price ~ontrat amount .0~1, pa}~able ~o BALI. The <br />rnini~num fee is the rt~~i~mut~ fey ~ 7a~o.~0. Without the f~ll~win completed information, t13~ <br />bureau ray be unable t~ pr~p~x~y credit you fir parnent received. <br />P~~LI A~VI~~'; its of Eu~en~ - Er~ine~rin~ EI I <br />AEI l~~~l AI~I}IE l~. ~road~va quite 4~~ <br />Iw~~"l~, TTE, I~: ~~t~, ~1 7~~ 1 <br />AE 1TAli~T ~EI~ L~~ ~ra~d~n 1~HE: 41~ <br />PIJET iIE lA)V~E; ~~vid tr~s 1~HE: ~~41 <br />P,IET NAME: a~~t~~vt~r 1v~~t~hal h~bilition ~t carious locations its the ci <br />ITA~' 11E if pert of ~ar~~r proj~~): <br />~TI~: ariou~ locations inthe city <br />I~1,I'T 44~ DATE ~TIAT F11T AI~EITIEi~: l~ll.~~ <br />DATE ~T1AT Aw1i~ED: 11171~~ ~TRATR BF 1~ <br />1T1~AT~1 BUIiE iA1~7 l~~; 11ic~~~l 1~~n db~ key ion <br />I~~TI~AT1 ~I~>~ 1~ Hv~lcins L~~~ <br />I`~Y'~ TTE~ l~u~~~, 1 ~74~ <br />~ <br />~1~A~ A~JIT; FEE AIICIT DiJEIPI~: ~-J <br />If less thin Ohl, is it part of a larger proaert? ❑y~s ❑no ontraet amoun# ~ .ool = f~ due <br />Please duplicate this form for 1`uture used <br />1 <br />~ ~ ~ <br /> <br />~I-I- ~1~~. ~1~ <br /> <br />~ <br />I v - k l <br />