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• <br /> . , � � <br /> ."N 7 � a- J... <br /> ,N, .J <br /> DEPARTMENT OF COMtAUNtTY DEVELOPMENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> ADDRESS �� ,�L[�c/�-/l.Oc� TYPE S�/� <br /> (1) BUILDING PERMIT FEE (���0' S ✓���` �' <br /> (A) PLAN CHECK fEE �Q � '7��5� <br /> (2) PLUMBINC /�;�. 00 <br /> (3) MECHANIC,".L 7• d� <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMII ISSUANCE ¢�- � <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR �� INCH <br /> (8) EXIST. WATER SERVIC[, APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> _ <br /> 0 <br /> 1 <br /> _CHART n <br /> (5) DRIVEWAY PERMIT TO BE PAId PRIOR TO BUILDING PERMIT IS• " <br /> SUANCE FEET DRIVEWAY(TYPE) S Z� ' � <br /> ., ., <br /> -i � <br /> $ NS <br /> — m <br /> 0 <br /> (7) STATUS OF SEWER CHAR("�S: <br /> ,� /J n� <br /> BOND DISTRICT FOOTAGE �`x� O3 <br /> N, 5, E, W =—R'zi <br /> NOTES �' � <br /> o z <br /> c <br /> a -a <br /> `J��,Bfi ��1�1J�: G�6�5 -"-ii� <br /> � <br /> �,en 9B¢� � � <br /> -� m <br /> SG',� �. `� � �. <br /> N <br /> O <br /> or <br /> c� m <br /> c in <br /> 3 (n <br /> m <br /> z c� <br /> SEWER CONNECTION CHARGES �m <br /> a <br /> YEAR TRUNK S � <br /> LATERAL = <br /> a <br /> z <br /> TOTAL CONNECTION CHARGES S i = <br /> � <br /> z <br /> SEWER PERMIT FEE b ��-0� —"� <br /> ., <br /> CATCH BASIN PERMIT FEE m <br /> TOTAL SEWER PERMIT FEES b ��� <br /> (7) MONTHLY SEWER CHARGES: <br />� SEWER CONSTRUCTION TRUCK g <br /> LATERAL <br />'� SEWER SERVICE <br /> l APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> t <br /> CHART <br /> INfO COMPILED BY: DATE <br /> APPROVAL: DATE <br />� s-ea <br />