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a <br />BUILDING PERMIT INFARMATION <br />ADDRESS TYPESt�tat,6 5 <br />(1) BUILDING PERMIT FEE ���b�0 •e� b— 3l9Z• `�'Z� <br />(A) PLAN CHECK FEE <br />(2) PLUMBINC �S' � <br />(3) MECHANICAL 2�"`'�� <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT SSUANCE � <br />(A) TO BE DETERMINED BY BLDC IP�SPECTOR 3�_ INCH �' <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION . <br />CHART F�'���8'-�� . : <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- � <br />SUANCE FEET DRIVEWAY(TYPE) E 2�'� <br />S <br />(7) STATUS OF SEWER CHARCES: <br />BOND -�_ DISTRICT <br />NOTES <br />SF�,/,a� UTtG/�' �� <br />o�� </�/ Bs' <br />!-�2 t7 � 79. Ba <br />�,rx� �?l-�� <br />$ � 5 �� <br />FOOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR � � TRUNK <br />LATERAL <br />TOTAL CONNECTION CNARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />TRUCK s <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />5•64 <br />CHORTI�"' 7��� <br />DATE _ <br />DATE _ <br />