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DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br />BUILDING PERMIT INFORMATION <br />r � � /� <br />ADDRE55 � � t � TYPE (-���.v�- <br />(1) BUILDING PERMIT FEE / �� �� $ �S3-�a <br />(A) PLAN CHECK FEE ��. � L��/4- � <br />(2) PLUMBINC l�'•�Q <br />(3) MECHANICAL /2. c�c� <br />(4) WATER SERVICE TO HE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��'aT�;v,�j — <br />(A) TO BE DETERMINED E3Y dLDG INSPECTOR INCH NJ�.cI ��n-urc�c <br />r+r�r:, �� s�4 „ <br />(B) EXIST. VVAiER SERVICE, APPLICATION NO. T <br />(C) APPROX. LOCATION i� "�•-�� �'-'��-�:ti �f'Ppon 33�� �� �'sr��+y H�U <br />,,/ .5��c� i� ��•� �� � , <br />�r �✓6'-�92v�-N u'� "7�' � �✓l�iST �.�Y �.� .ucu <br />E c�,� � ' CHART � -� % 3�¢'�M�E�v> ;E-�'�u= <br />(5J DRIVEWAY PERMIT TO B[ PAID PRIOR TO BUILDING PERMIT IS- �� <br />SUANCE FEET DRIVEWAY(TYPE) S �� � � <br />S <br />(7) STATUS OF SEWER CHARGES: (cS <br />BOND -� DISTRICT FOOTACE "�'- <br />N, S, E, �V <br />NOTES i <br />,�j�CLU�' Dc�/�ZG/'.�l6UT l`�• <br />�.� '%/f 8U <br />/�.�.� 2 <br />GGk�i.v� � f-'x-c�i. /� Ft�70 <br />%/G!U `� <br />�A�vfi �f'uc�,v �' .a�,oay ,n7� <br />Llr� c.i r;� f3i [rc. ��vy T-r�2 Zz�.e�c/ <br />c�M �j is-c.s:u Tv ���-,o�v4e3 zz� <br />M�Ti�'i :-b �-E.'UlG� /`' b�1sTiNy <br />�vrc:� /� Tv f_�x.� UT/c-/ztt�_ <br />SEWER CONNECTION CHARCES <br />YEAR �� � TRUNK S 4"� �' �� <br />LATERAL �,��� �S3 . 3 j <br />TOTAL COtJNECTION CHARCE� S ������'�� <br />�� <br />�""""' � oN7- 3 <br />SE`NER PE(ifv11T FEE / g ?n-0� <br />CATCH BF�SfN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />S[WER SERVICE <br />TRUC.K <br />LATERAL <br />S ��" �a <br />3 <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIrJ: Gp7 'ro P% .n,po,��o.� 22�r <br />� <br />�/ Oc-� b. ul �,cl� ,r�r_ L� r� r /J F'�nn� R r-T h � A/ i U lLJE' �- ���T � <br />M.//, i7•7 / <br />INfO COMPILED E3Y: <br />�°' APPROVAL: <br />5i <br />3` l3 <br />9-1�79 <br />� <br />� � CHART T �3"�'-8"q <br />DATE <br />DATE <br />� <br />'� <br />� <br />