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.� —R x�c� �-- /"� <br />� /ARTMENT OF COMMUNITY DEVELO�MENT SEIIVICES <br />BUILDING PERMIT INFORMATION <br />ADDRESS � ��7 ��_�L..�.,r�iin �p TYPE C-o�.s_ <br />(1) BUILDING PERMIT FEE l�59� v8(•`" f l+ic lOLb. 08 <br />(A) PLAN CHECK FEE �p,�QODBa <br />(2) PLUMBING (�p g <br />(3) MECHANICAL 3� „�.p <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PCRMIT ISSUAP;CE !00• i-9D <br />(A) TO BE DETERMINED BY BLDG INSPECTOR 'z INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION <br />CHART <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT i5- � <br />SUANCF. FEET _ DRIVEWAY(TYPE) S l� � <br />f <br />p) STATUS OF SEWER CHARGES: <br />BOND � DISTRICT <br />NOTES <br />3� FOOTACE 3 �q <br />N, 5, E, Q <br />SEWER CONNECTION CHARCES �� � <br />YE11R �- TRUNK S ���-i <br />LATERAL �K.'�Y•Z3 1 �,-SS'Xy'1 <br />TOTAL CONNECTION CHARGES 3?�9'��� <br />SEWER PERMIT fEE �3 �`� S l 3�. 6 O <br />CATCH BASIN PERMIT FEE 3/�/�� <br />TOTAL SEWER PERMIT FEES S <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK S l0. d.� <br />LATERAL �2-4 1 <br />SEWER SERVICE ►�+lE�r. <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />?149 <br />•]' <br />CHART -19-Z -S <br />DATE <br />DATE <br />