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' ' . <br /> DEPARTMENT OF COMMUNITY DEVELO►A9ENT SERVICES <br />� BUILDING PERMI�' INFORMATION , <br /> ADDRESS TYPE <br /> (1) BUILDING PERMIT FF.E 5 <br /> � (A) PLAN CHECK FEE <br /> (2) PLUMBINC <br /> (3) MECHANICAL — <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BL6C INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO: <br /> (C) APf'ROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SUANCE FEET _ DRIVEWAY(TYPF) S <br /> S <br /> (7) ST�TUS OF SEWER CHARGES: <br /> BOND DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> �;F��s ce <br /> � �_ ..,_. <br /> ..;a. <br /> i <br /> � <br /> �iri� <br /> �') Jl, ., y ��,- <br /> � ��� � � <br /> �`�� � <br /> ,.�`��'F4�"''ws � � ��:. <br /> SEWER CONNECTION CHARGES <br /> YEAR _ TRUNK S <br /> LATERAL <br /> TOTAL CONNECTION CHARGES 5 � <br /> SEWER PERMIT FEE � { <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES � <br /> (7) MONTHLY SEWER CHARCES: i <br /> SEWER CONSTRUCTION TRUCK 5 � <br /> LATERAL I <br /> SEWER SERVICE � <br /> APPRCX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: � <br /> CHART �, <br /> � I� <br /> INFO COMPILED BY: DATE � <br /> AP?ROVAL: DATE — <br /> I g..7g , . ,. . . <br /> -"�.�.. t s y;'��. 3 � <br /> � <br />