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_ 'l <br /> � <br /> �:�;�: ����� � � <br /> DE�ARTMEHT OF COMMUNITY DEVEIOIMENT9ERVICES I <br /> BUILDINV pERMIT INFORMATION � <br /> a <br /> ' �� <br /> ADDf�ESS ��� C2��: I�v� TYPE �-�e- <br /> (1) BUILDING PERMIT FEE �'TS� EL�O• °U � S Lo20•�O <br /> (A) PLAN CHECK FEE �'� 5��� � I: <br /> (2) PLUMBINC 44•D O , <br /> � 3�. cx� � <br /> (3) MECHANICAL � ' <br /> (4) WATER SERVICE TO BE PAIn PRIOR TO BUILDING PERMIT ISSUANCE 3�5��� i <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR � INCH �_��`'�' ��"i <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. ' <br /> (C) APPROX. LOCATION 4`CL .�A«+ �'��- 2orT C or ;' <br /> � Or G�T �W. AV�O• (i` GS. MAt.�J ApQ¢� : <br /> � �c�rr e 9s � <br /> er Tues.�pr..w�RT �//5 — � <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- • <br /> SUANCE «' FEET L�m�4T DRIVEWAY(TYPE) 3 4• O0 • - � <br /> S � � •`� i <br /> � <br /> (7) STATUS OF SEWER CHARGES: �' <br /> BOND _,�_DISTRICT 31 FOOTAGE �— <br /> _._ _ <br /> N, S, E, � <br /> ��,•., <br /> • NOTES - <br /> 6�6T.Lp�. Sl�N�E. C�faGCi � ` <br /> � .- ..._ .. .... . . - . . M. <br /> �• <br /> �A (.!�/q� �tD � , .. . � ........ . . . " . <br /> A ..,,_,� � . �... .: . . ..:...:.. .. � . . <br /> a�r-y_...� _ <br /> fj•�•�E.S� ., .. . <br /> .�r _. .. . .._ ._ . � <br /> 22l . .. _. <br /> .• . . - - - • SEWER CONNECTION CHARGES <br /> ._ _ .,.. ..:_.:..� YEAR 8I TRUNK S _ 4"Sd•Oh <br /> ..,'� ; . . -_.. .._.M_. LATERAL 16R0.C� <br /> _... .. :_ ..i.��... 2.oS�d,l.00 <br /> _..��....,. . -- _ - TOTAL CONNECTION CHARGES S <br /> ,._,`. '. ,r-... ur��,��. . . <br /> ^ { ,`,- <br /> }' <br /> -' �I e � , S 3p.BO <br /> � ,., � . , . .., „ „ � � SEWER PERMIT FEE <br /> ; ' CATCH BASIN PERMIT FEE <br /> . .,. , �` � 30,o0 <br /> `'-. '- TCITAL SEWER PERMIT FEES s -- <br /> (7).MONTHLY SEWER CHARGES: 3 48 <br /> , :y SEWER CONSTRUCTION TRUCK s <br /> , ; �,t LATERAL --�'�� .� <br /> • _ �'�— <br /> - SEWER SERVICE <br /> � ...� � oc crz�� � <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: �� <br /> ' - -- ---- "'-- ^--� iu.so ov� <br /> ici= - - - -P '� mW•o� �O Fr S bn M .l.I 4.�i " <br /> �, � e.�x�u 2r>_ n.�p�r HART�-' 31 z9'S <br /> �e ��$�SRT. SOP �l./�-�¢+ - � <br /> � 4+IAtu �,or T.+o.nPso� i (.c-t To p�V AyQI�( Ill vr Sof M.u.63 �: APAesti <br /> � �Lo�.p..aSa�.��' L {�� p c� esM.�.t.s� P A/P.a��t dMT. Oaa+ontf�L <br /> NFb(:UMPILtDtlY: ���. l.a-� -ru olt� �P/as �L�sv' DATE <br /> nPPROVAL: DATE <br /> ,. � .' <br /> �i•n <br /> � <br />