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)iNCIlli:(:Rn1r AND C0:1:11MI)T SENVICI;S- - <br />DUILDlIIf; l'1:IZ!l (I' T; MIUTA'1'MI <br />ADDRESS '1'7(1'li <br />1) BUILDING 1'1711:11T FEE $ ! 46.c9CJ <br />(A) PLAII CnCK FEE <br />2) PLUMBING $ . -:39 , © o <br />3) MECHANICAL <br />4) VATM SERVICE TO 13E PAID BEFORE BUILDING <br />PERMIT IS ISSUED $ 2- 1 j J -O <br />34 u. 40 - 2. <br />(A) TO BE DETERI4IaED BY PLBG. INSP, l.. INCH <br />(A) EXIST. WATER SERVICE, APPL. NO. <br />(C) APPROX. LOCATION 1Z" TD•T ,PPZC%, l P) �=T <br />CHART <br />ri) DRIVEWAY PrP,,IT TO BE PAID BEFORE BUILDI14C <br />MUMIi IS ISSUED FI T. µ&LlD/1.1 (TYPE) $ <br />G) STATUS OF SEWER CHARGES: TOTAL $ <br />I30'-\'D ttr DISTRICT 34 FOOTAGE BCD <br />Ni-Q91 El 41. <br />NOTES <br />7) flONTHLY SEWOR CHARGES: <br />SE('IER CON:I1 CTION CHARGES <br />YEAR _ %-_ TRUNK <br />LATERAL <br />$ "L2"0 .OD <br />$ 2(p5-oo <br />TOTAL CONNECTION CHARGE 4 8gj. oo <br />SP•IEP, PEMIT FEE 0 <br />CATCH BASIN PERM T FEE $ <br />TOTAL SMIE'R PERMIT FEES$ <br />SEWER CONSTRUCTION; <br />TRUNK <br />•LATERAL <br />$ (, • 75 <br />SEWER SERVICE <br />APPROX. <br />LOCATION 07 SIDE SE'IE R OR 'TEE <br />IN THE MAIN:* � ' /1/7/I <br />f ; <br />f1 • ot= <br />N�,�.. �i'J L'?�C.-PT�! <br />CHART <br />INFO CO`1P.:I,1:1) IM DATE <br />AV P IiOV,\T.: <br />DATE . <br />