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ENGINEERING DEPARTMENT <br />BUILDING PERMIT IDIFORMATION <br />ADDRESS G J% l� F^d e/' 9 r=' P.7 TYPE C o�t rv� <br />1) BUILDING PERMIT FEE <br />(A) PLAN CH�CK FEE <br />2) FiATliR SERVIC� TO B� PAID BEFORL' BUILDING <br />F'ERMIT IS ISSUED / „ <br />(A) TO BE DETERMINED BY PLBG. INGP. �_ ZNCH <br />$ <br />$ <br />27�,00 <br />$ ="o.�'__-0'° <br />(B) EXIST. '� Ce WATER SERVICE, APPL. NO. _f H 9 G 8 _ <br />(C) APPROX. LOCATION 2Q � S, ef N• ��� o� LeT 2'�i, <br />/2�� weSoc( wlairi CH11RT .5'-/ <br />3) DRI�'EWAY PERMIT TO BE PAID BEFORE BUILDING <br />YERMIT IS ISSUED � FT. y"� D/W (TYPE) $ <br />TOTAL* <br />4) STATUS OF SEWER CFiARGLS: !G6 <br />BOND TT DISTRICT__�( FOOTAGE .S�'r <br />N, S, E, W. <br />.fPwP�r ,- Jr�e /�Cc/ �I 20 OlU �o <br />No dra:nS f fl �0r�(i:.a� �,afi <br />r;x C:I1HKli�S: <br />SEWER CONSTRiJCTION: <br />SEWER SERVICE� <br />SEWER CONNECTION CHARGES: <br />YEAR �7� TRUNK <br />LATERAL <br />TO'PAL CONNECTION CHF.RGE <br />S <br />� <br />Y <br />� o, oa <br />SEWER PE?2MIT FEE Alta�'t: o � $ �' <br />CATCH BASIN PERMIT FEE��r�,6° $ <br />TOTAL SEWER PERMIT I'EES <br />TRUNK <br />LATERAL <br />FiPPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: /S�� rna n on F��.rino _ <br />s�d e s�we♦ %rcisl-: n 1 l7 2� iV n� /i /� in%tr Sc'rf�'on n� F/�-.,w 'n� <br />� , S' CHART v � - � � s' <br />INFO COMPILED BY: __ �iy^ ilATE 7�Z8�6 <br />REVIEW: <br />PROJECTS DIVISION <br />APPROVAL: <br />ENGINEERING DEPARTMENT <br />DATE <br />DATE <br />* This total must be paid before building permi.t is issued. <br />