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DErwRTMENT OF COMMUNITY DEVELOPMENT SERVICES <br /> BUILDING 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 BE PAID PRIOR TO BUILDING PERMIT ISSU NCH li <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR__.-- � <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. � <br /> (C) APPROX. LOCATION � <br /> CHART II <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BU��DRIVEWAY(TYPE) S � <br /> SUANCE �—FEET <br /> S <br /> (7) STATUS OF SEWER CHARCES: I <br /> BOND DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES 1 <br /> .. <br /> _;.._ <br /> _..._ , <br /> �.. '. � ..L.�,..._C .. -..i..-�.�..._v <br /> ) <br /> .. . ._....•�Y�:y�l�l!....,i:- . �...� . <br /> � �,� � x��—f�. <br /> , , :�a <br /> +� �!W w,"_ ..k.. . - .,a �.:.'s �-- <br /> .;.��( k"; i a t � �a-(�a,i., <br /> � Y n A. � - � j � b�. <br /> o.�L.P 'rl� '~' .�V � r-':� -�.i}�t Yt ti: <br /> .:. . � �. TPu�.naV/+� <br /> . . . . . .. . . � . ti.�� <br /> �. .� - . -1..i�. <br /> ...., �.��.�.„. ..:;���,� <br /> �.;:. <br /> SEWER CONNECTION CHARGES <br /> --�""�"""', TRUNK S <br /> .:�.-�.,.. :w.t� YEAR <br /> tr:^""xm;"""-'"" LATERAL <br /> :,,.,,...�:,. <br /> �;�� TOTAL CONNECTION CHARGES b <br /> ...�N.ra�.:��N. <br /> � � SEWER PERMIT FEE $ <br /> �... �'�: <br /> CATCH E3ASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES $ <br /> (7) MONTHLY SEWER CHARGES: TRUCK $ <br /> SEWER CONSTRUCTION <br /> IATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART <br /> �_ DATE <br /> INFO COMPILED BY: DATE <br /> APPROVAL: <br /> , �,�� „ r — <br /> _ , ._, � <br /> � a a <br /> • Yu � <br /> � . _ _ . . _ ,. � tF � �s ;� � ��1� � <br /> � ,� <br /> . . , - ,- . ._... ._ .�' �; �s.Ti F�F:d ia <br /> . ��o-tn�i. .. ' - � F�fi, ,..s .w�.r <br /> i: , � . ? , <br /> ' i . .... � .. . . , � ... <br /> � . r�1�� ,;;N. .. . � � . <br /> 9�1�79 , - '`. ,r. �. . ' _'_ .. . . .._ <br /> . , � ' .� ...i. ,..: = <br /> .. .. <br /> a. + . ... . , �. _.. �...�..w.•»:-- . . . . . <br /> .�_ y„�.a�-',.0 �._.,�.tiy.n�......-...-..� <br /> I� � <br /> F <br />