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ENv^INEERING DEPARTMENT <br />BUILDING PERMIT INFORMATION <br />ADDRESS , �A;�,�'� <br />1) dU1LDING PERMIT F^E 1' �'. ` r <br />(A) PLAN CHECK FEE ��3, �7 Y� <br />z) WATER SIRVICE TO BE PAIU PEFORE BUILDING <br />PERMIT IS ISSUED <br />TYPE_ " , ., <br />$ �3��. (�Y, <br />S= �"�{,5a <br />$ <br />(A) TO DE DETERMINED BY PLBG. INSP. ':.� INCH ��-'+ <br />(B) EXIST..'�_ WpTER SERVICE, APPL. Np. �,�;•, . ,,,M�N <br />y. . � — <br />(C) APPROX. LOCATION �� • _ �� / � ' <br />�` .; + � 7 . <br />S. 6 1" � E (• ['� 1' � 1.� Y� CHART ; <br />S) DRIVEWAY PERh:IT TO DE PAID BEFORE BUILDING <br />PERMIT IS ISSUED .2p FT <br />_ � . - <br />_ r , <br />-- ' �/W (TYPE) S � � ��� <br />9) STATUS OF SEWER CHARGES: TOTP.L* <br />BONU_�__ DISTRICT FOOTAGE '��' %� / <br />N, S,(E; W. <br />��i .C�C $E.t<ef.� C. n;tru ��.'j'�eq <br />c�ta.1 p �i S2. -1.�; � (r:.,1.;.,.,) <br />/�Q Y �Ft � :� � n i• Y '% <br />.r� .�.,, ,, -.�.��;. (�y6zsD� <br />A���r. 3 os oz.� �� <br />I"C'� �r,�, �. <br />SEWER CONSTRUCTION: <br />. , <br />s 4- J � .SZ% <br />�3EWER CGNNECTION CHARGES: � O __ <br />YEAR � � �,; TRUNK � $ <br />�—i-+..r�--�.�.- <br />LATERAL -jj4- $ �� <br />TOTAL CONNECTION CHARGE � $ c� <br />SFWER PERMZT FEE $_ 3�� �� <br />CATCH BASIN PF.RMIT FEF.�e�Y• $ —� <br />TOTAL SGWER PERMIT FEES $ 3C `�- <br />1`RUNK S O 2p <br />Lt.'i�RAL $_ �,� _� _ <br />SEWEk SERVICE: <br />S r� R f �.b-d <br />',!�PROX. LOCATION C�F ^IDE Sr�•:;;R OR TEE IN THE MAIN; � i" ,�. ,{ �� N <br />, <br />.__ f 7� py�. '�- <br />I V!`O COMPILED BY: <br />RI:VIEW: <br />PROJE� DIVISION <br />APPROVAL: <br />— I°NGINLERING DEPATcI'D;ENT <br />- ' G'ZF.—,� <br />DATE �-'- Z �_ -��, <br />DATE <br />D.T�TP ���___ <br />"'Chis tot;�l must be paid t;efore building pernit is issued. <br />