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., <br /> _ '1 <br /> 1 <br /> �F,) J ' <br /> �":.. <br /> DE►ARTMENT OF COMMUNITY DEVELOYMENT SERVICES <br /> . . <br /> BUILDING PERINIT INFORMATION � <br /> . � . � � <br /> ADDRE55 59/O �•/t�c� . - -1 �I�� TYPE ��UU�n.vi . . , . <br /> (1) BUILDING PERMIT FEE �275� �'�' S �70•Sb <br /> (A) PLAN CHECK FEE P�� ��¢S/ <br /> (2) PLUMBINC 7¢ -a U <br /> (3) MECHANICAL �¢•5T� '� <br /> (4) WATER SERVICE TC BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��✓�Q • D 0 <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR -� �f INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATIUN <br /> • , , . , i , . <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS• � v <br /> SUANCE 3S FEET �A RIVEWAY(TYPE) S �7' S <br /> S �2 0 96 'i <br /> (7) STATUS OF�EWER CHARGES: <br /> BOND __�+�_DISTRICT � FOOTAGE 2� <br /> N, S, � W <br /> NOTES <br /> �E3.u� Z��I�Z.O�.v�Eu-j- }�� �CLQir»uC � - �2�5�.°� <br /> G1�2� 7l5-80 <br /> � � <br /> 20Z �C �3t9 ,�-} _ �(oZZ9 �1e8 <br /> SEWER CONNECTION CHARGES <br /> YEAR �3- TRUNK f ZQZ"� <br /> LATERAL «��"�d <br /> TOTAL CONNECTION CHARGES S l`�j� 8• Oo <br /> SEWER PERMIT FEE S 3d'�� <br /> CATCH BASIN PERMIT FEE �"�a <br /> TOTAL SEWER PERfv11T FEES f ��� <br /> (7j MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S <br /> LATERAL <br /> SEWER SERVICE ���C��'� <br /> � <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART �- �-Z$-S' <br /> INFO COMPILED BY: DATE , � <br /> �1PPROVAL: DATE <br /> �7•79 <br /> � <br />