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DEPAR7MIiNT OF COMMUNITY DEVELOIMENT SERVICES ';�
<br /> BUILDINC PERMIT INFORMATION
<br /> ADDRESS TYPE
<br /> (1) BUILDING PERMIT FEE $
<br /> (A) PLAN CHECK FEE
<br /> (2) PLUMBING
<br /> (3) MECHANICAL
<br /> (4) WATER SERVICE TO RE PAID PRIOR TO BUILDING PERMIT ISSUANCE
<br /> (A) TO BE DETER�'v11NED BY BLDG INSPECTOR INCH
<br /> (B) EXIST. WATER SERVICE. APPLICATION NO.
<br /> (C) APPROX. LOCATION
<br /> CHART
<br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUI�DING PERMIT lS-
<br /> SUANCE FEET DRIVEWAY(TYPE) S
<br /> 3
<br /> (7) STATUS OF SEWER CHARGES:
<br /> dOND DISTRICT FOOTAGE
<br /> N, S, E, W
<br /> NOTES
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<br /> �••��-,�,�-^! SEWER CONNECTION CHARGES
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<br /> YEAR
<br /> "'" ' LATERAL
<br /> ���. �-�=� TOTAL CONNE�TION CHARGES $ _ �
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<br /> SEWER PERMIT FEE $
<br /> CATCH BASIN PERMIT FEE J
<br /> TOTAL SEVJER PERMIT FEES $ �
<br /> (7) MONTHLY SEWER CHARGES: S ;
<br /> SEWER CONSTRUCTION TRUCK
<br /> LATERAL
<br /> SEWER SERVICE I
<br /> APPROa. LOCATION OF 51DE SEWER OR TEE IN THE MAIN: 1
<br /> CHART
<br /> INFO COMPILED BY:
<br /> DATE � �
<br /> 4PPROVAL• DATE
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