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� <br />t� <br />, ,_. <br />DEMRTMENT OF COMMUNITr DEVELO►MENT SERVICES <br />BUILDING PERMIT INFORMATION <br />ADDRESS TYPE _ <br />(1) BUILDING PERMIT FEE s <br />(A) PLAN CHECK FEE <br />(2) PLUMBINC <br />(3) MECHANICAL <br />(4) W/1TER SERVICE TO 8E PAID 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) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE FEET DRIVEWAY(TYPE) S <br />S <br />(7) STATUS OF SEWER CHARGES: <br />BOND DISTRICT <br />NOTES <br />FOOTAG E <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK S <br />LATERAL <br />TOTAL CONNF.CTION CHARGES S <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: ._ <br />INFO COMPILED BY: <br />APPROVAL: <br />S <br />S <br />E? <br />_ CHART <br />DATE _ <br />DATE _ <br />� <br />J <br />� <br />1 <br />