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, <br />DEMRTMENT OF COMMUHITY DEVELOPMEN7 SERVICES <br />BUILDING PERMIT INFf��..v1AT10N <br />ADDRESS ��� � '�"`'``� ���-�-'�- TYPE 5•�� • <br />f1) BUILDING PERMIT FEE �OaOC`�C�• � 5 4'�3.Bd <br />(A) PLAN CHECK FEE %(�`t�7 ���•ZS — <br />(2) PLUMBING 2¢ �d � <br />(3) MECHANICAL 2�'�`'� <br />(4) WATER SERVICE TU BE PAID PRIOR TO BUILDINC PERMIT ISSUANCE ��'�-`� � <br />(A) TO BE DETERMINED BY BLDC I�lSPECTOR �t�— �NCH <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- ZO.OU <br />SUANCE FEET DRIVEWAY(TYPE) 3 <br />��y s� <br />(7) STATUS OF SEWER CHARGE'�: <br />80ND � DISTRICT FOOTAGE <br />N, 5, E, W <br />NOTES <br />S �1 �. � . {— �.-'� <br />c�2� 484-83 <br />S �2 <br />�8� o0 <br />SEWER CONNECTION CHARGES <br />YEAR 8S TRUNK <br />LATERAL <br />TUTAL CONNECTION CNARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARCES: <br />SEWER CONSTRUCTION <br />SEWER SERVICE <br />TRUCK b <br />LATERAL <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />I NFO COMPI LE D BY: <br />APPROVAL: <br />s-an <br />CHART <br />DATE <br />DATE <br />Z <br />0 <br />� <br />� <br />m <br />�� <br />.. .� <br />N 2 <br />m <br />v <br />co <br />m o <br />c� <br />O 3 <br />m <br />�z <br />x -i <br />m <br />4= <br />c <br />a -i <br />rx <br />.. .. <br />-i �n <br />� <br />T, <br />o� <br />�a <br />--� m <br />_ <br />mN <br />v <br />or <br />c� m <br />c �n <br />3 N <br />m <br />z� <br />-� r <br />• m <br />a <br />A <br />�--1 <br />2 <br />a <br />Z <br />-� <br />x <br />N <br />2 <br />O <br />� <br />.. <br />c� <br />m <br />� <br />