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<br /> � BUILDING PERM17 INFORMATION , ' ; ��� '�
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<br /> ADDRESS q GfDrAI�l�T TYPE . , ,.li: j;
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<br /> � (1) BUILDINC PERMIT FEE ' b ' � ���'� ,',�, •
<br /> � (A) PLAN CHECK FEE 5 �a• �s -�� s.fJd /�'�� GS' '� �i
<br /> (2) PLUMBING ��.�— :j '.t
<br /> (3) MECHANICAL �IS�C7'� ;' t."
<br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT i55UANCE GJSO�� � ." ' ,
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<br /> (A} 70 BE DETERMINED BY BLL�G INSPECTOR �� INCH i !�
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<br /> (B) EXIST. WATER SERVICE, APPUCATION NO. : ; ;�� ��
<br /> (C1 APPROX. LOCATION � � � �_� '' iR
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<br /> (5) CRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- �� pp ! � '!1��. C�
<br /> SUANCE FEET DRIVEV��AY(TYPE) S� � � ' � �, j�
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<br /> (7) STATUS OF SEWER CHARGES: , � ' ' " � '"'� `
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<br /> BOND ��DISTRICT FOOTAGE _
<br /> � " N, S, E, W �. 1 �� ] �
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<br /> �,� ���� �IOTES �� .�
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<br /> SEWER CONNECTION CHARGES • ���
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<br /> YEAR TRUNK b '�7 ';
<br /> LATERAL � �r
<br /> TOTAL CONNECTION CHARGES b �4.
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<br /> SEWER PERMIT FEE 5 I;:
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<br /> CATCH BASIN PERMIT FEE rj:
<br /> TOTAL SEWER PERMIT FEES E �� �'`
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<br /> (7) h10NTHLY SFWER CHARGES: f�'
<br /> SEWER CONSTRUCTION TRUCK � ' �'��y �'
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<br /> SEWER SERVICE � �
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<br /> APPROX:LOCATION OF SIDE SEWER OR TEE IN THE MAIN: i;�
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<br /> DATE ���
<br /> INFO COMPILED BY: '',
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<br /> APPROVAL: ;.
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