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� <br /> DF►ARTMENT OF COM7NUNITY DEVELOPMEN7 SERVlCF:S <br /> BUILDING PERMIT INFORMATION <br /> r ADDRESS TYP[ ���� <br /> (1) BUILI�ING PERMIT FEE 4�r���'� S �}?f •CU <br /> (A) PLAN CHECK FEE k• �7 nc� �= <br /> (2) PLUMBING � � '�� U — <br /> (3) MECHANICAL � fZ� U(J _ ..! <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE BZI`�ii�vt� _ <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR � INCH <br /> �� <br /> (8) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) �PPROX. LOCATION �°��M�/.tJ L�'P.�E�r 2t�� t dw' <br /> � B� ���Li—CHnRT�T�7-Z9- 5 <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILUING PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) S �C�. UU <br /> E _ <br /> (7) STATUS OF SEWER CHARGES: <br /> BUND DISTRICT FOOTAGE <br /> N, 5, E, W <br /> NOTES <br /> SCWER CONNECT�ON CHARGES <br /> YEAR _ TRUNK 3 _ <br /> LATERAL _ <br /> TOTAL CONNECTION CHARGES 3 _ <br /> SEWER PERMIT FEF S _ ��' t-`�U /Sd.'f. <br /> CATCH BASIN PERIvtIT Ff:E <br /> TOTAL SEWER PERMIT FEES S _ � �•�U �kr��`�`' <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK E <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX, LOCATION OF SIDE SEWER OR TEE IN 7HE MnIN: 8"N»i,rJ bfv.¢t�,i f�F'7 � <br /> �__Df� D/� �E:.�/- L/�7 'TU ���-t�Ti,t�, �.yrnti. r. .�i= .Qf�P.G'dx <br /> 2/U f*� �j' p/� NJ./,/. �l/y-,tJ �Tr'� ,04Lr� CHART T�17-Z9-S <br /> INFOCOMPILED BY: DATE <br /> L APPROVAL: DATE <br /> , on <br />