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� <br /> . �,>o , , <br /> DEIARTMEMT OF COMMUNITY DEVEIGPMFNT SERVICES <br /> BUILDING PERMIT � NFORMATION <br /> r ADDRESS _TYPE � � '�"� <br /> (1) BUILDING PERMIT FEE ���jOf�O •�� S �/Cv DU <br /> (A) PLAN CHECK FEE �� � ���z'� <br /> (2) PLUMBING —2�� � <br /> (3) MECHANICAL � �' �Z� � <br /> (4) WATER SERVICE ?O BL F'AID PRIOR TO BUILDING PERMI ISSUANCE �I-E��• ��� <br /> (A) TO BE DF_7ERMiNED BY E3LDG INSPECTOR ��. INCH f " �13t-��t.( Stt�2� <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION 8�� ���� �f'<%o-� iUF> <br /> �� or � af' �i✓i�HnR�/�� �- 3`�- Z4--� <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> iUANCE FEET DRIVEWAY(TYPE) S -�•�� <br /> 5 <br /> (i) STATUS OF SEWER CHARGES: <br /> 90ND �DISTRICT FOOT�GE _ <br /> N, 5, E, W <br /> tJOTES <br /> SEWER CONNECT ON CHARGES <br /> VEAR _ � TRUNK S �" ���• ��U <br /> LATERAL ¢ c�� • � D <br /> TOTAL CONNECTION CHARGES E ? z'� � �v <br /> SEWER PERMIT FEE S 3Ch• DC� <br /> CATCH BASIN PERMIT FEE - <br /> TOTAL SEWER PERMIT FEES 3 �G-D!� <br /> (7) MONTHLY SEWER CHARG�S: <br /> SEWER CONSTRUCTION TRUCK 5 <br /> LATERAL — <br /> SEWER SERVICE <br /> APPROX LOCATION OF SID[ SEWER OR TEE IN THE MAIN. ''-/1����� �f�''��'� � <br /> � o<' �A`/U/L�(� L.CI ,['� � ,c�n c..,u�z�,a� � .��- <br /> _—� CHART P" ?a-� ' "z�f- <br /> It:FO COMPILED BY: _ DATE <br /> L APPROVAL: DATE _ <br /> 5 84 <br /> (_ <br />