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,. <br />'� _ 'l - <br /> 1 <br /> � <br /> DE►ARTMENT OF COMMUNITY DEVELO►MENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> 1 <br /> ADDRESS TYPE <br /> (1j BUILDING PERMIT FEE a <br /> (A) PLAN CHECK FEE <br />� (2) PLUMBING "� <br /> (3) MECHRNICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) S <br /> 3 <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND DISTRICT FOOTAGE <br /> N, 5, E, W <br /> NOTES <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK f <br /> LATERAL <br /> TOTAL CONNECTION CHARGES S <br /> SEWER PERMIT FEE S <br /> CATCH BASIN P[R1v11T FEE <br /> TOTAL SEWER PERMIT FEES 3 <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S <br /> LATERAL � <br />--� SEWER SERVICE _ <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: _ <br /> CHART <br /> i <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> 9�1.79 <br /> 1 � <br /> �� <br />