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,,>. • �• - <br /> ; , �;;s:l <br /> �. <br /> BUILDING PERMIT INfORMATION <br /> ADDRESS TYPE <br /> (1) BUIIDING PERMIT FEE 7o7� oZ0(7 s `S/�' 5��--- <br /> (A) PLAN CHECK FEE 333 ?6 — a3 9 � `/3 ; <br /> (2) PLUMBING �� � <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TU BUILDINC PERMIi� ISSUANCE �n�7� <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR `-� INCH <br /> �V .�-C> <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. — <br /> (C) APPROX. LOCATION <br /> CHART_ <br /> (S) nRIVEWAY PERMIT TO BE PAID PRIOR TC' BUILDING PERMIT IS- � <br /> SU/tNCE FEET DRIVEWAY(TYPE) S O "r <br /> s ��59 — <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND DISTRICT FOOTAGE <br /> N, 5. E. W <br /> NOTES <br /> I 1"11'F3:5 �l�.t�a'' 1"19� <br /> �..��',r' lh 1 `z <br /> c��� <br /> SEWER CONNECTION CHARGES � <br /> s <br /> YEAR TRUNK S <br /> G <br /> LATERAL <br /> TOTAL CONNECTION CHARGES S ���� _ <br /> SEWER PERMIT FEE s <br /> � <br /> C.ATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES S '�— � <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK s — <br /> LATERAL ' <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: , <br /> CHART <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> rm <br />