HomeMy WebLinkAboutM.P. Mountanos, Inc. 2017-02-13Connection Fee Deferral Agreement FMu
NIS APPLICATION# 1519
Planning and Community Development Department
City Of Ukiah
300 Seminary Avenue
Ukiah, Ca. 95482
(707) 463-6207
APPLICANT- PLEASE PRINT CLEARLY AND FILL ALL APPLICABLE SECTIONS
Connection Fee Deferral Program
The Connection Fee Deferral Program allows to defer payment of impact fees until certificate of occupancy.
Project Name: M. P. Mountanos, INC
Project Site Address: 406 Ni School Street, Ukiah, CA 95482
Project Description (Attach additional sheets if needed)
Convert existing commercial building into 4 1 -Bedroom apartments
APPLICANT: Name and mailing address of
person requesting the fee deferral.
NAME: M. P. Mountanos, Inc
COMPANY:
ADDRESS: 605 N State Street
CITY / STATE / ZIP: Ukiah CA 91;427
PHONE#: (707) 462-1840
E-MAIL ADDRESS: MP@pacific.net
SIGNATURE:
OWNER: Person who will be responsible for
payment of deferred fee when due.
NAME: Mark Mountanos
COMPANY: M.P. Mountanos, Inc
ADDRESS: 605 N State Street
CITY / STATE / ZIP: Ukiah, CA 95482
PHONE:
E-MAIL ADDRESS:
SIGNATURE:
Total amount of connection fees deferred:
Sewer: $31,751.01
Water: $ 4,888.65
TOTAL: $36,639.66
Payment information: There will be no building permit issued until all fees other than the deferred connection fees are
paid.
Projects receiving fee deferrals are not eligible for temporary occupancy.
I hereby submit this Connection Fee Deferral Agreement for review by the City of Ukiah. All information contained
herewith is true to the best of my knowledge.
Person Responsibly f pa menta
Signature: ✓ Date:
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Copies to:
Project Permit File:
Finance Controller:
Senior Management Analyst:
City Clerk:
(Original)
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