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FOR OFFICE USE ONLY <br /> ADDRESS $ <br /> (1) BUILDING PE�IMIT FEE <br /> (A) PLAN CHEC FEE <br /> (2) PLUMBING <br /> (3) MECHANICAL <br /> (4) STATE SURCHARGES <br /> (A) BUIIDING CODE <br /> (8) ENERGY CODE <br /> (5) DRIVEWAY PERMIT $ _ <br /> (6) WATER SERVlCE TO BE PAID PRIOR TO UILDING PERMIT ISS ANCE $ <br /> (A) TO BE DETERMINED BY BLDG. INSPEC R <br /> INCH <br /> (B) EXIST. WATER SERVICE.APP CATIO O. <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND_—DISTRICT FOO GE N, S, E, w <br /> SYSTEMS DEVELOP ENT � <br /> WATER �'� <br /> .� SEWER <br /> i� <br /> � TOTAL ORD. FEE <br /> / / SEWER CONNECTION CHARGES <br /> �� YEAF_--TRUNK $ <br /> LATERAL <br /> TOTAL CONNEGTION CHARGES $ <br /> SEWER PERMIT FEE ,_ $ <br /> ,,- �. <br /> �,�:.. <br /> .�.a, w i_ .; <br /> + -� �y r�a; a`�a-ri <br /> _ ».� ,� 3 �«.ut� R :;�,_ ,.w.t <br /> : s�4'�i'iri�, i ;_,�„, _� ...,� -r -�—' s< S <br /> .._ _ .t+5�r t r+.�'^.-w �" �,�... . �u. v�+��w�^"� ,'�� ;�`'���i� .�N.`�y-. .... <br /> S�.wc:+arw+i�... � . <br /> ..�...� i .<� r � , _.....Af�' � . .. �� � <br /> , . . ..�� _ � , a L l <br /> # '�, I x� ��+��r,t� � �...�� '� ': , <br /> ir,ra � � ..� � � � ,�,�`"�-- .,�„=` �' � I <br /> n�,lx .�., M �,� ,s« '-/ e �,fi.Y. � �3,v_. <br /> hy <br /> ..�. _._. � ' . � , �"�..� (, wy <br /> .. � � ,.,a. ..w��f� r :,a4 � ^r .y ..... � M <br /> �Ir�a i'TC _..__ _., _.L_._.._.�.,. �... r_... � �..r. :.t >� ,. i - a, <br /> _.___ . ,. ..., ..,� . ..�.: <br /> __. .. , 1k.aNC1 <br /> "'� r,�, _ <br /> � ___ � w.�� �� `" r�"r��� �r . <br /> .. .�.__. y y ��,i_j. . <br /> I ' * ` _ <br /> , , <br /> x -��.w- >... ,- <br /> � U <br /> �' <br /> .i,A. . ... � .... � i fE�r.�H . +kA,rykl � ,': M ,...� ��_���r <br /> mTAI+«ik.5 a ��'� �.. . .�. . ��° <br /> + - ,.3y c\-k:+, ,�G--+.+� 'r'1 <br /> 5'� <br /> Y � n.a.w..r++++,..a.awro'.�1' 15 ♦ *��Nl] � u � ' <br /> ,V N' 19r..�E- }Yl�.ii. �� �"4'r. y _ <br /> . � �`'y�A�eVl1�i""�'{,.�_.�� " ` •1 <br /> � r - wa Y . ai�9 �li8• <br /> . r a- {�.. .- . ' . xM�'a,Ca,� , J - i 4 �j� <br /> � A'4� ' � y : 5 1 � �i$5 �Fib.:':. �. � <br /> , , .; . i , � r'-A',-'z3.c 4a`d^P•����T'�'�;`4�� 7�� � <br /> i rY-+: � �.. , . __ . •� • � r�;.a�s.� � <br /> ,. ! . . . ,...0 _,�'� � <br /> :.5 i ., .,+� ' �.,�Y.',+�A `�� <br /> : S_. .'_ . _ .., ��' ^ N4 k � �+nlw� s>� ���� �ri <br /> o a ���,: - ai{ i� �x,'���1p� �Y'':k_�lTS <br /> . I_ h;..�Grs��.G�C . . . <br />