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<br /> BUILDING PE�MIT INFORMATION ; ; , .. . ,�; i
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<br /> ADDRESS ? 93 � �' Y��� ��• TYPE ,�'��'�, i
<br /> (1) BUILDING PERMIT FEE (pZ�•� 5 4 � Z ����� '
<br /> (A) PLAN CHECK FEE i:f �
<br /> (21 PLUMBING . SS�D� ' �'�� ;
<br /> (3) MECHANICAL U �� � �`��
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<br /> (4) WATER SERVICE TO BE PAID PRIOR TO 6UILDING PERMIT IS UANCE ��0' i,p
<br /> (A) TO BE DETERMIN[D BY BLDG fNSPECTOR � INCH
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<br /> (B) EXIST. WATER SERVICE, APPLICATION NO. � �'�
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<br /> (C) APPROX. LOCATION , ., . , �"
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<br /> CHART _ ��
<br /> (5) DRIVEW^Y PERMIT TO BE PAID PRIOR TO BUILDING PERMIT 15- 2Oy Bd �' �
<br /> � SU/1NCE /���'FEET t DRIVEWnY(TYPE) S � �;i�;,
<br /> , ;; . . . . ' 1 ' �: � I � .'. . ' . ... ' � .�1 .
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<br /> p) STATUS OF SEWER CH�RGES: , , ' ' 'j +i� :�� I 'i , . '; �'. ' '
<br /> BOND S DISTRICT � FOOTAGE {��j
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<br /> N, S, E, W
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<br /> NOTES � +��(�
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<br /> �.CG: Ur�L��► �' . -,(
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<br /> r1�fZt� l/7/--85 ' `''.C?�i�t� �T' ?9'�/ ' '�' .
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<br /> 6 G5a• 7,� / . 7b 8E ,oa�csi� lD�. �'�'
<br /> , . ,� SEWER CONNECTION CHARGES /��� �
<br /> �� � , YEAR S7 TRUNK 3
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<br /> � LATERAL
<br /> , �,, : TOTAL CONNECTION CHARGES S
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<br /> SEWER PERMIT FEE s �O.�Z� __ _
<br /> CATCH BASIN PERMIT FEE M� •
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<br /> ' .. TOTAI_ SEWER PERMIT FEES E
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<br /> (7) MONTHLY SEWER CHARCES:
<br /> i SEWER CONSTRUCTION TRUCK s � .,.
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<br /> LATERAL
<br /> SEWER SERVICE
<br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: -
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<br /> � • • � CHART `
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<br /> � ,INFO COMPILED BY: DATE '-
<br /> APPROVAL: DATE ,.
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