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FOR OFFICE USE ONLY <br /> ADQRESS <br /> (1) BUILQIhG PERMIT FEE $ <br /> (A) PLAN CHECK FEE <br /> (2) PLUMBING <br /> (3) MECHANICAL <br /> (4) STATE SURCHAfiGES <br /> (A) BUILDING CODF <br /> (B) ENEFiGY CODE <br /> (5) DRIVEWAY PERMIT <br /> $ <br /> (6) WATER SERVICE TO BE PAID PRIdR TO BUILDING PERMIT ISSUANCE $ <br /> (A) TO BE DETEFMINED BY BLDG. INSPECTOR INGH <br /> (B) EXIST. _WATER SERVICE.APPLICATION NO. <br /> (7) STPTUS OF SEWER CHARGES: <br /> BOND DISTRICT FOOTAGE <br /> N, S, E, W <br /> SYSTEMS DEVELOPMENT <br /> WATER <br /> SEWER <br /> TOTAL ORD. FEE <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK $ <br /> LATERAL <br /> TOTAL CONNECTION CHARGES $ <br /> SEWER PERMIT FEE $ <br />