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. , <br /> i. ., , �'�I �, <br /> . I <br /> BUILDING PERMIT INFORMATION ' <br /> ADDRE55 � "��Vd' d�p� C �+ � CNp�'TA.Lf.�_TYPE S�G��+���A���� <br /> (1) BUILDINC PERMIT FEE �ZO OO�•�� S O S� _ <br /> � �8��Z�� <br /> (A) PLAN CHECK FEE �� <br /> � l.00•d'�` <br /> (2) PLUMBINC $g 6� <br /> (3j MECHANICAL � <br /> (4) WATER SERVICE TO BE P�ID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR ( INCH <br /> (8) EXIST. WATER SERVICE, �PPLICATION NO. <br /> (C) APPROX. LOCATION � M��� a•N.�'�'nr ld ��r != , rtrc <br /> i <br /> �J {'1..��� 1 I,u �(- —CHART S -1�-29- S� <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- ZQ ,Q � <br /> SUANCE .�—FEET DRIVEWAY(TYPE) S <br /> S <br /> p) STATUS OF SEWER CHARCES: <br /> BOND + DISTRICT —' FOOTACE ���b <br /> N, S, E, W <br /> NOTES <br /> 5Plzl�, t,lTt��T( � d�'C�. (�g-� � <br /> e�2I� !.l?l- 9b— 2W <br /> ���� ��O� �� <br /> I <br /> SEWER CONNECTION CNARGES • <br /> = YEAR ` TRUNK S <br /> LATERAL <br /> TOTAL CONNECTION CHARGES s — _ <br /> SEWER PERMIT FEE S 3��� . <br /> �� <br /> CATCH BASIN PERMIT FEE s ��v <br /> TOTnL SEWER PERMIT FEES s <br /> (7) A10NTHLY SEWER CHARGES: s <br /> SEWER CONSTRUCTION TRUCK <br /> LATERAL ; <br /> SEWER SERVICr. �I <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: $���'�A� � � `� �'" � �«�,� � <br /> -' e� Nh�l. � <br /> -�f=ES (o�GMt T �7 F*7 l7 a-�7- 2f-`�" <br /> CHART <br /> INFOCOMPILED BY: ._ DATE <br /> DATE <br /> APPROVAL: <br /> ��. �c �3� 'Ty <br /> — -- <br /> 5•B4 <br /> �-- <br />