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r <br /> r <br /> DEMRTMENT OF COMMUNITY DEVEl01'MENT SERVICES � <br /> BUILDING PERMIT INFORMATION <br /> � ADDRESS � �2d �`4���'� ��z TYPE �• � � { <br /> (1) BUILDING PERMIT FEE ���� � $� 20. �L�� �c= <br /> (A) PLAN CHECK FEE �� � v <br /> (2) PLUMBING ,L(�.vU <br /> (3) MECHANICAL <br /> (4) WATER SERVlCE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��' �v <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR� INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION �"c-L Mni� �a�`'n" / .F7 <br /> 5 Q� � OG�a�l�n__�+CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- 7 �� <br /> SUANCE � '!� FEET ,���'J�7 DRIVEWAY(TYPE) S <br /> E <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND ^� DISTRICT FOOTAGE <br /> N, S, E, W <br /> ' NOTES <br /> �;�ST�v� �t��t7Hvl�U7 f�= <br /> �� [�co�—8 c� <br /> T�� 4 <br /> �5F�.00 S.F�, <br /> SEWER CCNNECTION CHARGES <br /> YEAR �'� TRUNK S 27lJ`dd — <br /> LATERAL ¢���v <br /> TOTAL CONNECTION CHARGES 5 �720 OG� <br /> ���{G`� 5 �,oU <br /> SEWER PERMIT FEE <br /> CATCH BASIN PERMIT FEE ��O <br /> TOTAL SEWER PERMIT FEES E <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK 5 - <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: � ��'� `�- �� �°n� <br /> - 7 p . �i - J, <br /> " � -7'r�o.nn (Dj! ' /���'� CHART 5-7-28- 5 <br /> �(.� �Ld/ �.-/11 J/.J `� <br /> / �T �G��P� i <br /> INFO COMPILED DY: DATE <br /> DATE <br /> � APPROVAL: <br /> 41�79 <br />