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. ��"� �'�%�� <br /> _ � ENGINEERING DEPARTMENT /���,1 <br /> RUILDZNG PERMIT INFORMATTON � 9� � <br /> ADDRESS Si�D /w/ - N s�t'�r�'���/. � .�✓ civ,v;� <br /> — YY • �,�:' :�,�;1.�J .�C��`?, . TYPE cG/+t!'v�� .-�f_�.s/�•- <br /> lI BUILDIHG PERMIT FEE {���r�r.. ` L .:'..'� � 5 zc�9 pa ✓ <br /> (A) PLAN CHECK FEE S l(o/,k 5'v <br /> 2) WATER SF.RVZCE TO BE PAID BEFORE BUILDING �'�'` ' ��' Y� `x` <br /> PERMIT IS ISSUED ✓ <br /> � <br /> �S1 _ <br /> (A) TO BE DETERMINED BY PLBG. INSP. INCH { � 7_�,.i'".!/; � <br /> (�) EXIST. .`J WATER SERVICE, APPL. N0. �'���_ -' <br /> (C) APFROX. LOCATION :X'a-,-' 7-- ' i <br /> —--�- '�" � �f'�/� ,-�y�-�i�?. <br /> n i., ' . K �'_'.,�T�"�l.�'Z';�: U '7"--T <br /> Ga-��; .f.T-i� � A.l. .:-� �'. �.`- �a'J�r? <br /> CHART �� <br /> 3) DRIVEWAY PERMIT 4'O BE PAlD BEFORE,BUILDING / <br /> PERDIIT IS ISSUED :�'�; FT, i -. 't �/ <br /> :nL�/�/. __ .D/W (TYPE) �,S—t=t��. <br /> i — <br /> - TOTAL ey 7 7-�-' �z�`.� <br /> 4) S;ATGS OF SEWE.t CHARGES: <br /> BO':Dr__ DZSTRICP F00"AGE � ' _ � � '�' � <br /> iN{ S, E, W. <br /> NOTl5 S�WER CONA�ECTION CNARGES: <br /> , � c C- YEAR ��Y _ TRUNK S_,�Z-ZO. �-i <br /> .�(o G �d I <br /> `7/ s /� 7�., 5C? <br /> TERAL 7 <br /> • T 'FA�` CQ�b����CHARGE S Z�.�3. LS <br /> � <br /> I SEk'ER PERM7T FEE $ ���,�(�� <br /> 1r, G�. l'O �� <br /> CATCH BASIN PE T FBE � $ --- ? -- <br /> TOTAL SEWER PER(�IIT FEES <br /> 5) '•--• _. :,1' SEItiER C}fARGES: 5 J'n•� <br /> -� <br /> SEWER CONSTRUCTIOtit <br /> TRUNR g ��� �� <br /> T.ATERAL $ �7 S� <br /> SEi�IER SERVICE: $�st�� <br /> APP�'O/�[• ' J�.+TION OF SIDE SEWER OR TEE IN THE MAIN: �,-� . / �{f� � iv, v � <br /> �'fY•_ S�__ G..41itii0 �� -�il,�'_jic`3u,1/ ? � ��u <br /> � -- � CfiART - -� -�"`�— <br /> IhFO C���:7IiED BY: _-G+Cti�-7 ,� . ��t�,f jy� DATE �'� <br /> — _�— �1_;s.� <br /> REl'I E��: <br /> - DATE <br /> �RUJE S D VISION --' - -- <br /> APPR.;'.:'•.',: �_ DATE � "� � ' <br /> � F.NGINEERING DEPARTMENT — <br />