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" � ' �:;.� ar�� <br />DEMRTMENT OF �OMMUNOTY DEVELO►MENT SERVICES <br />BUILDING PERNr11T II�fORMATION <br />ADDRESS _ � �Z8 �Z,�y ��� TYPE J �i2. <br />(1J BUILDING PERMIT FEE ��' <br />: _ 22y0d <br />(A) PLAN CHECK FEE + a8"� !/,_70 IJUG <br />(2) PLUMBING / �� O� <br />(3) MECHANICAL �I�� �,2 0 p <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILnINC PERMIT 155UANCE �� <br />(A) TO BE DETERMINE <br />D BY BLDC INSPECTOR � �NCH <br />(B) EXIST. WATER SERVICE. APPLICATION NO. <br />(C) APPROX. LOCATION.�E�" �a�f ,p� � T <br />{JT '�� �L�� CHART <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS-6��f � <br />SU�NCE FEET DRIVEWAY(TYPE) S �LO�� <br />S <br />(7) STATUS OF SEWER I:HARGES: <br />BOND �_DISTRICT <br />NOTES <br />FOOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARCES <br />YEAR — ��� TRUNK f �Z ?O, 00 <br />LATERAL �-- <br />TOTAL CONNECTION CHARGE5�2�'� 270.0�7 <br />SEWEk PERMIT FEE <br />CATCH ' • `.SIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARCE5: <br />SEWER CONSTRUCTION <br />S —d��.6�C7 <br />d `�S�F � <br />S =�=�.f'c� <br />7RUCK S <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SE\NER OR TEE IN THE MAIN: _ <br />INFO COMPILED BY: <br />Ai'PROVAL: <br />stac <br />_t�.�l. <br />_ CHART � �—�8 `� <br />DATE <br />DATE <br />�7 <br />� <br />� <br />r <br />