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� <br />DEPARTMEHT OF CUMMUNITY DEVELOPMENT SERVICES <br />BUILDING PERh�11T INFORMATION <br />ADDRESS TYPE <br />(1) BUILDING PERMIT FEE $ <br />(A) PLAN CHECK FEE <br />(2) PLUMBINC <br />(3j MECHANICAL <br />(4) WATER SERVICE TO BE ?AID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDG INSPECTOR _ INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION - <br />CHART <br />(5) DRIVEYVAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUAN�E FEET DRIVEWAY(TYPE) $ <br />S <br />(7) STATUS OF SEWER CHARGES: <br />BONCJ DISTRICT <br />NO1 ES <br />FOOTAGE <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERM,�T FEE <br />TOTAL SEWER PERIvtIT FEES <br />f7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />S <br />3 <br />S <br />S <br />TRUCK $ <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFOCO��PILEDBY: _ <br />APPROVAL: <br />41•79 <br />CHART <br />UAIE <br />DATE <br />��. <br />