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DE�ARTMENT OF COMMUNITY DEYEI.O�MENT SERVICES <br />BUILDING PERMIT INFORMATION <br />A,nDRE55 TYPE <br />(1) BUILDINC PERMIT FEE b <br />(A) PLAN CHECK FE[ <br />(2) PLUM6�MC <br />(3) MECHANICAL <br />(4) Wn i cR SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BI.DC INSPECTUR INCH <br />(B) EXIST. WATER SEicVICE, APPLICATION NO. <br />(C) APPROX. LOCATION <br />CHART <br />(5) DRIV[WAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE FEET DRIVEWAY(TYPE) S <br />S <br />(7) STATUS OF SEWER CHARGES: <br />BCiJD DISTRICT <br />NOTES <br />FOOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARGE_�• <br />YEAR TRI;��K <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT F[E <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FE�S <br />(7) MONTHLY SCWER CHARGES: <br />SEWER CONSTRUCTI�N <br />TRUCK S <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SID� SEWER OR TEE IN THE MAIN: <br />iNFO COMPILED BY: <br />APPROVAL: <br />41 79 <br />CHART <br />DATE <br />DATE <br />