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- ;>.� . <br /> I <br /> � <br /> BUILDING PERMIT IN]'ORDdATION <br /> ADDR�SS i/ f`�%GJ` ��' ( G�/C� �j� <br /> TYPE OI' IIUILDIATG �, �� , DATE /Z/� � <br /> 1) BUILDING PI;RMIT P'�E � `_ I <br /> (A) PLAN CH�CK I'�� ' � _ <br /> 2) l'dATI�R SF_RVIC� TO IIE PAID II�FOR� BUILDING <br /> PERMIT IS ISSU�D � � <br /> (A) TO 33� D�T�RMIN�D BY PLBG, INSP, INCII <br /> �! <br /> (B) �XIST. WAT�R SL•'RVICE, APPL. DIO. <br /> (C) LOCATION , <br /> CIIART <br /> 3) DRIVL:\i'AY PliR\4IT TO BE PAID I3�r'ORE BUILDING <br /> PERn4IT IS ISS�JED FT. ll/1ti (TYY�) � — <br /> TOTt1L�� S � <br /> 4) STFlTUS OF SL11'ER C1-1ARGES: <br /> BOND ,L llISTRICT �_ FOOTAG� <br /> N, S, �, �Y, <br /> LA\DSC.APIJ NOTISS S�\'J�R CONN�CTIOAT CIiARGES; <br /> � TRUNI{ t; 9'S�d <br /> LAT�RAL S '— <br /> TOTAL CONATECTIOAT CI-LnPG� $ 9S OQ <br /> S�19ER P�RI�QIT F�� c� 30, �Q ` <br /> CATCH BASIN P�RVIIT i'E� � — <br /> TOTAL 5�1V�R P�RMIT I']��S $ J�• QQ <br /> 5) b10NTI-ILY S�Z1'ER CI-IARGI:S; <br /> SEIYER CO\'STRUCTION; <br /> TRUI�TK � j�D,z0 <br /> LAT�RAL $ — <br /> SE1V�12 SL;P.\'IC�; � Z �O <br /> LOCATION OF SID� SL\V�R OR T�� IN 'I'I-I� r4AIIQ: CI-IART 5—�2—���� <br /> S. S , �9( � .�` o � /v/ L� /� �"t- ��i Z � it/ � ,!i/�_ <br /> �. ' �-o Z l,. C G...� 7,.�� � � o � <br /> inro co�-;i� LLv nr• nn�r� <br /> i:���rL�v: DnTL <br /> �r�;E�r•i�IC llNISIOA' <br /> nn;�l;ovni.; nn•rr <br /> 1sNGINL•'LRING D�YARTMliN'1' <br /> '�°'This toYal �in�:;t bc paid Lofore lniil:lini; permii is issucd. <br /> —� �..�,,.:_._ <br /> - s� r ��- <br />