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�° . <br /> BUILDING PERMIT INFORMATION <br /> ADDRE55 ��b �nrn•S �l�l° TYPE <br /> (1) BUILDING PERMIT FEE S � <br /> (A) PLAN CHECK FEE �9 � <br /> 00 <br /> (2) PLUMBINC � <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE �/��i� <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR � �� INCH I�6 � <br /> (B) EXIST. WATER SERVICE, APPIICATION NO. <br /> (C1 APPROX. LOCATION <br /> CHART <br /> (5) DRIYEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- � <br /> SUANCE FEET DRIVEWAY(TYPE) 1 0 <br /> s 1�31 <br /> (7) STATUS OF SEWER CHARGES: <br /> 6�ND DISTRICT FOOTAGE <br /> N, 5, E, W <br /> NOT E S <br /> I �`l �-85 1'?9-a �� <br /> �l� 1 �= �.� <br /> �50 °� <br /> SEWER CONNECTION CHARGES � <br /> YEAR TRUNK S ���� <br /> LATERAL y�� <br /> TOTAL CONNECTION CHARGES S �� � <br /> SEWER PERMiT FEE s � � � <br /> CATCH BASIN ?ERMIT FEE � ' <br /> TOTAL SEWER PERMIT FEES f �',� <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK s <br /> L/1TERAL <br /> SEWER SERVICE <br /> APPROI(. LOCATION Of SIDE SEWER OR TEE iN THE MAIN: <br /> CHART <br /> INfO COMPILED BY: DATE <br /> APPROVAI: DATE <br /> 1M <br />