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�yOR � i <br /> � ' �� � v`iF'x`� <br /> i n <br /> � � <br /> BUILDING PEk�MIT INFQRMATION <br /> , � <br /> AODRESS _ �v "� 7 G�Nvr a��Q�e <br /> (1) BUILDINGF�RMITFEE S _ y ��--S/� <br /> (A) PLAN CHECK FEE <br /> (2) PLUM[iING �-�u�-- <br /> (3) MECHANICAL — ��d� <br /> (4) STATE SURCHARGES — „ <br /> ��� (A) BUILDING CODE --_ y�.5� <br /> p � (9) ENERGY COUE ^1 <br /> (5) DRIVEWAYPERMIT ZD�OV <br /> ��� � -- ( S7- D� <br /> �tl w� (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE S . �S�LO�Z-- <br /> �q[ (A) TO BE DETERMINED BY BLDG. INSPECTOR�l�_ INCH <br /> �� (B) EXIST. WATER SERVICE. APPLICATION NO.____ ____—._ <br /> �A (7) STATUS OF SEWER CHARGES: � <br /> Q1-�� BOND � DISTRIC7____ FOOTAGE _ <br /> Z�y N. S. E w I <br /> L" <br /> M <br /> W <br /> �� ORDINANCE 1171-85 <br /> WATER _—J Z5 OO__ <br /> �� SEWER —� OG <br /> TOTAL ORD. FEE <br /> ' � SEWER CONNECTION CHARGES <br /> � <br /> 1 �� YEAR_ TRUNK S _ �S G6 <br /> i � LATERAL —_—��7.�-- <br /> TOTAL CONNECTION CHARGES S ___ 7o�S �0 <br /> — - ; <br /> � D G� <br /> I � SEWER�PERMIT FEE 5 _____�� <br /> I�� �i� � %1�,c� <br /> , s� <br /> SS 0 <br /> � I�I s�0 <br /> � � s d <br /> i—� <br />