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DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br />BUILDING PERMIT INFORMATION <br />ADDRESS _TYPE <br />(1) BUILDING PERMIT FEE $ <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDII�G 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 PERP�IIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE _ FEET DRIVEWAY(TYPE) $ <br />S <br />(7) STATUS OF SEWER CHARCES: <br />80ND DISTRICT <br />NOTES <br />FOOTAG E <br />N, 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(') MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />S <br />Ej <br />F: <br />S <br />TRUCK $ <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR T[E IN THE MAIN: <br />INfO COMPILED BY: <br />APPROVAL: <br />41�79 <br />CHART <br />DATE <br />DATE <br />� <br />