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� <br /> DEf..KTMENT OF COMMUNITY DEVELOPMEhi SERVICES <br /> BUILDING PERMI� INFORMATION <br /> ADDRESS �} ?�� G�• ��s�+dv�� � � TYPE � � 'e <br /> (1) BUILDING PERMIT FEE //(qBpp.� $ .31�• BQ <br /> (A) PLAN CHECK FEE PA• '-���� � <br /> (2) PLUMBING 28.'O D <br /> (3) MECHANICAL «"�U <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING P[RMIT ISSUANCE L�`�'�' " O� <br /> (A) TO BE DETERMINED BY BLDG INSPEC-i OR �_ INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION4" C.= Tr*t-pv e� � ��nveerty C� <br /> R.c�wc.�-�,,ro r.,+� ge�.c�-,¢� I'�c. . <br /> CHART � ' 3d. <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUI�DING PERMIT IS- � <br /> SUANCE 2O FEET ��'uG• DRIVEWAY(TYPE) S �� � <br /> g 5�8 .00 <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND -� DISTRICT � �' FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> c5�/L� . 7-zz - 8a <br /> ,�p S^ <br /> �i � ��� �-E�. m v <br /> SEWER CONNECTION CHARGES - ' <br /> YEAR ' '�'� � 'I TRUNK S � ''�` <br /> LATERAL �; i�- ��o 'd � <br /> TOTAL CONNECTION CHARGES $ ' `-''Z� <br /> ,. - - <br /> �. , (. <br /> SEWER PERMIT FEE g ��. m b _ <br /> CATCH BASIN PERMIT FEE �C��� <br /> TOTAL SEWER PERMIT fEES c ��/�/ S 3�7- �D <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S � ' Z � <br /> LATERAL 2 ' � � <br /> SEWER SERVICE _ S� / b <br /> aAPPROX. LOCATION OF SIDE SEWER OR TEF. IN THE MAIN: c`� �/t-be[U /S�G�/�h--ro• ✓ <br /> r7Ql3A�•o�/,/_�7_ Tc� Trf6 �.OS'T�LS� GfL OF GOT /Z• �is!» 5�� ".+' . <br /> / D trr �.� �0�,- �' �` !!4 � r �' /�/O � CHART p- z✓C.o-Zq-G <br /> o�s 7�E /'�1lJ�T EAST'�t��- c�1¢.c/mt � o'r �Z <br /> INFO COMPILED BY: DATE <br /> APPROVAL: _ DATE <br />