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DE�ARTMENT OF GOMMUNIIY DEVEIO�MENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> ADDRESS TYPE C��� • <br /> (1) BUILDING PERMIT FEE l� ppd� Qpp, o0 5 2 (o83.C� C7 <br /> (A) PLAN CHECK FEE PD• '�' 75�LDD <br /> (2) PLUMBINC 2�' � � <br /> (3) MECHANICAL S¢ . O d <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) CXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SUANCE FEET _ DP.IVEWAY(TYPE) 5 �3-�� '�� <br /> S <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND � DISTRICT FOOTAGE �Z'4S ' <br /> N, 5, E, A� <br /> NOTES <br /> 5E3.t� D�11� 7=�'�' <br /> �-'�-'� ��4-83 <br /> �.�T,ott- `jPAGE <br /> s�29o."��C .0881 = soBt, tDl <br /> SEWER CONNECTION CHARGES ' <br /> YEAR 8s TRUNK b �q�• Z� <br /> LATERAL ' L0�9 �O <br /> TOTAL CONNECTION CHARGES S ll9g�' g� <br /> SEWER PERMIT FEE $ � '� <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEFS $ <br /> (7} MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> ARPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> � CHART <br /> INFO COM?lLED 8Y: DATE <br /> APPROVAL: QATE <br /> / _ <br /> ;�/-,. : - ;_� ::.� � /� /,��� , <br /> � 1r, :J/. .._!�� <br /> ' �. �. • ,�� <br /> 5�84 <br /> � , <br />