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� <br /> a.^, w'•� <br /> � DEIARTMENT Oi GOMMUNITY DEVELO►MENT SERVICES <br /> BUILDING �'ERMIT INFORMATION <br /> „ . � , <br /> NDDRESS �/ 9 �Ga:�-� �_.r,-�..c L �'�r_: 1YPE GC�i�� �I <br /> (1) BUILDING PERMIT FEE s <br /> (A) PLAN CHECK FEE �� � � ��� <br /> (2) PLUMBING <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO [�E PAID PRIOR TO BUILDING PERMIT ISSUANCE � <br /> (A) TO BE DE fERM�NED BY BLDG INSPECTOR INCH <br /> (B) EXIST. � WATER SERVICE, APPLICATION NO � <br /> (C) APPROX. LOCATION _�_ ��p� npp2ox !b �r � <br /> C�F' �-o�' �-I���.�o� eC�HART �Z -IL-ZS -Q- <br /> (5) DRIVEW'AY PERh11T TO BE PAID PRIOR TO HUILDING PF:RMIT IS- <br /> SUANCE FEET DRIVEW'AY(TYPE) S <br /> S <br /> (7) STATI ` DF SEWER CHARGES: <br /> 80ND �.'.IT�—DISTRICT FOOTAGE _ /7� <br /> N, � E, W <br /> NOTES <br /> �/!3L � G�G)ci.v�7'rc-x� G�,�.oir�,e;s <br /> �.0 98¢-83 <br /> ,�'a- �� '� <br /> =+�–�"T F� 5��4LE SEWER CONNECTION CHARGES <br /> F,n�ni�� l�si�sr.c-E G/��/ YE/1R �"� TRUNK S SG(o•/ 7 <br /> � ��y �,����� LATERAL d '22•�l0 <br /> TOTAL CONNECTION CH�RGES S `�2�• �7 <br /> cHA24E <br /> SEWER PERMIT FEE s �'�r� <br /> CATCH BASIN PERMIT FEE — <br /> TOT�L SEWER PERMIT FEES 3 = �•�?d _ <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S — <br /> LATERAL — <br /> SEWER SERVICE — <br /> APPROX LOCATION OF SIDE SEWER OR TEE IN THE MAIN P�� Mn„c,.i d Ur <br /> �l •• /Il <br /> ��l„� � �oT To P�� ��� �s� �. r.� o� ,���. � <br /> }��� �OD2tr� Lo�'r' 'Zt�' vT F'�C.. C HAR T � - /2- 2 9- S <br /> INFOCOMPILED BY: DATE <br /> APPROVAL: _ DATE J <br /> S BA <br />