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i. 4["� <br /> YI1f� • <br /> rt �^ � � <br /> � � <br /> ( I <br /> ^��� BUIi.G?�ING PERMIT INFORNRATION <br /> � w�w.•y <br /> ^ 4 <br /> V � <br /> ��� ADDRESS _ ��0 ��/�0'��rrnd_ �__ - --- ! <br /> � • (1) BUILD!NGPERMITFEE 7„Z3. S(7 - 59•�S(c.u��(� $ ---����Z <br /> : <br /> ��� (A) PLANCHECKFEE �pd,$��l3 — y�o, � = y�,.,5 ,,,,,�1�- -- <br /> �lR� (2) PLUWiBING --�-`�!�'��.�-- <br /> Q� (3) MFCHANPCAL �—�'y"-- <br /> QA� ; (4) STATE SURCHARGES -- -- � , <br /> �H (A) BUILDING CODE ---���— � <br /> ��� (B) ENERGY CODE — f . <br /> .�.� (5) DRIVEWAY PERMIT Z U'-p� <br /> � : g S?� R , R-5_ <br /> �� / c � : <br /> - (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ �Zp <br /> (A) TO BE DETERMINED BY DLDG. INSPECTOR 3��--_ INCIi � <br /> (� EXIST. WATER SERVICE APPLICATION NO.-__—_-. __ i <br /> (7) STATUS C1F S[WEF CHAR�dES: �,/� �� <br /> 80ND�vpt��-_ DIS7RICT_i�'_— FOOTAGE N, S, E w � <br /> ORDINANCE 1171•85 p <br /> � WATER -----I-� 11-OG_--- <br /> i <br /> SEWER — -�-1-'��---._ i <br /> C�� ; TOTAL ORD. FEE __ -_�5���-- I <br /> � , <br /> � � SIcWER CONNFCTION CHARGES � <br /> � i �� �s YIcAH--- - - -- -_ TRUNK S - ------- - --- I <br /> i <br /> � Li>TERAL ---- ' <br /> ,_� : TOTALCONNECTIUN CHARGES S ___ ___ j ; <br /> , , � <br /> `. i I ' <br /> � SEWER PERMIT FEE $ -- .--�Q-��� ! <br /> � w� i <br /> �� �� a , � �a .�-� � <br /> �, �i� <br /> , <br /> I LI`1 a � s , ► , oca � s� ! <br /> � . , �I 5_ '�- :�r � <br /> 'y I G ncv �-- � <br /> 1375 � � ; d , <br /> . j I O Dy ( UOU �. <br /> _ ����T � ps .� <br /> � � 3 7 �s -��2 5" � <br /> � i �� <br /> �C�____ <br /> iy9, 795 <br /> i <br />