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. , <br /> � <br /> D!. ��TMENT OF COMMUNITY DEVELO�M, f SE�VICES � <br /> �UILDING PERMIT INFORMATION <br /> ; <br /> ADDRE55 _��/ � 1 ]Q �Gr GVefe� TYPE �� IG�G/1?'r dl <br /> (1) BUILDINC PERMIT FEE f <br /> (A) PLAN CHECK FEE <br /> (2) PLUMBINC <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDC INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. _._ <br /> (C) APPROX. LOCATION _ <br /> CHIIRT <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS- � <br /> SUANCE FEET DRIVEWAY(TYPE) f <br /> s ' <br /> (7) STATUS OF SEWER CHARGES: <br /> � BOND DISTRICT FOOTAGE <br /> ' N, S, E, W <br /> NOTES <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK f i <br /> LATERAL � <br /> TOTAL CONNEC710N CHARGES f <br /> SEWER PERMIT fEE S <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES i <br /> p) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK i <br /> LATERAL <br /> SEWER SERVICE j <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART <br /> INFOCOMPILEDBY: _ DATE <br /> APPROVAL: DATE <br />