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r <br /> n <br /> I <br />� <br /> DEP....TMENT OF COMMUNITY DEVELO►MEN't SERVICES <br /> BUIL.D� NI,; PERMIT I �VFORMATION <br /> ADDRESS ���`-� ��d�=vAY TYPE _ LOM�-�s. <br /> (1) BUlLDING PERMIT FEE ���i E-�• � g 332. �� <br /> (A) PLAN CHECK FEE O� Du� <br /> (2) PLUMBING �2 ' � <br /> (3) MECHANICAL _ QB • � <br /> (4) WATER SERVICE TU BE PAID PRIOR TO BUILDING PERMIT ISSU�NCE _J� 7S o[� <br /> w <br /> a <br /> �a (A) TO BE DETERMINED BY BLDC INSPECTOR �e INCH <br /> i91 EXIST. WATER SERVICE, APPLICATION NO. <br /> wen�too <br /> (C) APPROX. LOCATIG�I ���G�L Mai.�J �, ee� �c� L <br /> �."Nu.ea a.anaow r�'t�r¢'CHA�RT��/7¢� 5- 177 <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- � <br /> SUANCE 2 "2S FEET A�'��T DRIVEWAY(TYPE) S �6' "' <br /> S <br /> (7) STATUS OF SEWER CHARGF.S: np <br /> BOND � DISTRICT �FOOTAGE 2�� <br /> N, 5, E, (C� <br /> NOTES <br /> �QET.�C.dC- LJ�Ub6 G6�>2Ctt� P�"�OLIJ La(cQ-80 <br /> QeZ(s-b �- 1�7c . c.ic� <br /> � �,� �T� � I'�t: '6�..Pc,� .suAa..� lF <br /> W O�. �P�r3M �-+�OOOw sy� <br /> 2"�t+�¢-� !Yz" 43us.� 9urr�.r tt-� <br /> WAZ'Et. g¢OH NOwAWo . <br /> L�t�ou ru 'Fa� SEWER CONNECTION CHARCES <br /> 'ACZ��u""'n T'�( W'°�e"YEAR g� TRUNK $ q53'�QO <br /> 'fl�� <br /> LATERAL �`�'8��03 <br /> TOTAL CONNECTION CHARGES S 2�3�7•Q3 <br /> SEWER PERMIT FEE � �y � $ 3D•Da <br /> CATCH BASIN PERMIT FEE � '���I�d <br /> TOTAL SEWER PERMIT FEES � $ <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S �� 2 'Z <br /> LATERAL 8.4�3 <br /> SEWER SERVICE ME�'� <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: 8�`��� �o�h �B�r � <br /> A-► � OF �IefLY� ,urlF y LAT ZO P�L /YI�Pr/� �r0 �,T E 0� M,E( 23.Z <br /> � `D�PTr,r l,l�A�-iri� CHART X- �9 -'2R�5 <br /> T � <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> �.,�;� <br />