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DEPARTMENT OF COMMUNIri OEVELOPMENT SERVI�ES <br /> BUILDING PERMIT IN�rORM�TION <br /> ADDRESS TYPE <br /> (1) BUILDING PERMIT fEE b <br /> (A) PLAN CHECK FEE <br /> (2) PLUMBING <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TO RUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION � <br /> CHART " II <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR 70 BUILDING PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) S � <br /> E I <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND DISIRICT fOOTAGE <br /> N, 5, E, W � <br /> NOTES � <br /> I <br /> �I <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK 3 I <br /> LATERAL i <br /> TOTAL CONNECTION CHARGES E ' <br /> SEWER PERMIT FEE 5 ' <br /> CATCH BASIN PERMIT rEE � <br /> TOTAL SEWEK PERMIT FEES 4 <br /> (7) MONI rfLY SEWER CHARGES: i <br /> SEWER CONSTRUCTION TRUCK s — � <br /> LA7ERnL � <br /> SEWER SERVICE I <br /> APPROX. LOCATION Gf SIDE SEWER OR TEE IN THE MAIN: <br /> � <br /> CHART_ <br /> I <br /> DATE i <br /> INFOCOMPILED BY: � <br /> DATE <br /> APPROVAL: <br /> ' <br /> � <br /> i <br /> i <br /> 9-1 79 � <br /> II , <br /> ! <br /> J <br />