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. • � • 1 • _ ! . . � . s • • � <br /> BUILDING PERMIT INFORMP TION <br /> ADDRESS �Q'I� /, � �i �� '!�"� . <br /> TYPE OF BUILDING � �. � � � , DATE � i i�'7� <br /> 1) BUILDING PERMIT FEE �G, �0�� � 5��7 �U <br /> (A) PLAN CHECK FEE S LO� <br /> 2) WATER SERV:rE TO BE PAID BEFORE I3UILDING <br /> PERMIT LS ISSUED ��� S ��� C1 � C� () <br /> (A) TO BE DETERMINED BY PLBG. INSP. .-�J� INCH <br /> T�� <br /> (B) EXIST. WATER SERVICE, APPL. NO. <br /> (C) LOCATION �" ��• G /�Ir���/ Co�-,a,-�r�� ��'/%n'�Y� /c> <br /> Lu ��f' ��l �/� CHART �.0 - '`(� <br /> 3) DI2IVEWAY PERMIT TO BE PAID B�FOR^ BUILDING /� � � � � <br /> PERMIT IS ISSUED � _1 FT, /�•_(j�/�JCi D/W (TYPFJ� �_/7�7(� O� I <br /> r� zJ� � �/ <br /> . r OTAL $ !b3• <br /> 4) STATUS OF SEWER CHARGE : <br /> BOND . .TL DLSTRICT �� FOOTAGE _ <br /> , , E, W. <br /> LANDSCAPE NOTES SEWER CONNECTION CHARGES: <br /> TRUNK s /�'U�C�C� <br /> 3 -ZFr- 2�4 - Ob ��AT��I,� J �n��.� n� <br /> l 1 C1f L"71 <br /> � TOTAL NECT40N ¢HARGE $ �(Q,S . U O — <br /> SEWER PERMIT FEE S 3C�. U �J <br /> CATCH BASIN PERMIT FEE $ - <br /> TOTAL SEWER PERMIT FEES $ �O . O G� � <br /> � 5) MONTHLY SEWER CHARGES: . <br /> SEW.ER CONSTRUCTION: / <br /> � TRUNK a �� I� <br /> LATERAL S o2. �S <br /> SEWER SERVICE: S a�1^U J <br /> LOf'ATION OF SIDE SEWER OR TEE IN THE MAIN: CHART y�J�-a��- � <br /> �;���ti�7 PD (,�e:17' �t. /�f�M //0 �N�K%//c�F ,�'lN fli�ii�r,� � F),�6i',?r ���L'Pk'�!y Y�qr <br /> � <br /> �iTd .'S O;V �cf - � ;1 ' : .i/ A�i�i �i :LCi✓d�C° !.�'+. . Cv . i/�/`� . i . . i i� ���vi .SIUJ� id <br /> INFO COMPILED Y: " C C', DATE Z���Y-� r <br /> itEVIEW• � '��-��----�- DATE `J IS� <br /> �TRAFFIC DIVISION <br /> APPROV AL: .'�^�- DATE ✓ �ZL-7�^ <br /> GINEERING DEYARTMEN <br /> *Tliia total muat be paid betore building permit is ieeued. <br /> i <br /> . . . , <br />