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DEPARTMENT OF COMMUNITY DEVELOPMENT �ERVICES <br /> BUILDING PERMIT INFO�MATION <br /> ADDRESS TYFE _ <br /> (1) BUILDING PERMIT F[E S <br /> (A) PLAN CHECK FEE - <br /> (2) PLUMBING <br /> (3) MECHANlCAL <br /> (4) WATER SCRVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A? TO BE UETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXlST. WATER SERVICE, APPLiCATION NO. <br /> (C) APPROX. LOCATION <br /> CHART <br /> (51 DRIVEWAY PERMIT TO BE FAID PRIOR TO BUILDING PERMIT IS- <br /> S� ;p,NrF FEET DRIVEWAY(TYPE) $ � <br /> S _ <br /> (7) S'+ATUS OF SEWER CHARGES: <br /> BOND DISTRICT _FOOI�AGE <br /> N, S, E, W <br /> NOTES <br /> SEWFR CONNECTION CHARGES <br /> YEAR TRUNK S <br /> LATERAL ' <br /> TOTAL CONNECTION CHARGES S __ <br /> SEWER PERMIT FEE S <br /> CATCH BASIN PERMIT FEt - <br /> TOTAL SEWER PERMIT FEES g - <br /> 1 <br /> (i) MONTHLY SEWER CHARCES: <br /> SEWER CONSTRUCTION TRUCK 5 <br /> LATERAL - <br /> SE�VER SERV�CE <br /> APPROX. LOCATION OF SI[SE SEWER OR TEE IN THE MAIN: <br /> _ CHART _ <br /> INFO COMPILED BY: DATE <br /> APPROVAL: _ DATE <br /> ,, -,� <br />