|
�
<br />;:,, -,
<br />�:,? ���>�
<br />BUILDING PERMIT INFORMATION
<br />;tt, ADDRE55 �-�l''L� �V�I% �J�• TYPE
<br />(1) BUILDING PERMIT FEE 5 ���% p
<br />- (A) PLAN CHECK FEE --
<br />0
<br />(2) PLUMBING
<br />(3) MECHANICAL r ---
<br />(4) WATEit SERVICE TO BE PA17 PK�OR TO BUILDINC P MIT� ISSUANCC �
<br />• (A) TO BE DETERMINED BY Ci.DG INSPECTOR `�_ INCH l�' U
<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 F[ET DRIVEWAY(TYPE) 3
<br />:r � � 5 --
<br />:� . _
<br />,�
<br />=� p) STA'fU5 OF SEW.ER CHARGES: '
<br />`� BOND DISTRICT FOOTAGE
<br />� ' • N, S, E, 1Y
<br />I '1�±�; .: NOTES o�o�L, � 1/�-Y�-�
<br />,., . , 1171-85
<br />;�; .... . ... . . .. .. ;. .. . .. . .. ��f �
<br />I . ... .. . _ _ ; �
<br />=� ., i
<br />!at.. , .��• t-- ��,
<br />I 'r • }�..« . 1
<br />i;l;.. � 1;.._ ... .
<br />t,n I ., .. ti , . ;��: j
<br />I���� , � _� . . ..._.. , ..... . . . . . . . . . , . ...
<br />1! ... r��j � � �! , _ `
<br />��L .• ' � .♦ ._A. . . .
<br />� 1 .... ..� .., .... . .�.. .. . . , ...
<br />�:: .. (.._ . N ._ . � ' . '
<br />, ,��' � " SEWER CONNECTION_CHARGES
<br />. ' e �.... ��:.: :_ . . .
<br />� i �� YEAR TRUNK
<br />�� �
<br />�` �a . :,
<br />f ,' 1;. I�f : ^ ' TOTA CONNECTION CHAR
<br />i _. ..
<br />� � ' GES
<br />.�., ... . . � �_.
<br />� � �,,� �., . . � .. . �
<br />� r'^ { � ! �� � . �j�._,. .. . ,. . ...:. . . . ' ... . �.
<br />I : ..
<br />.��. ..T , ir...,. - .. _._ .. SEWER PERMIT FEE ._
<br />�C` �''i � ��; �' '"' " ,�.CATCH B.AS!N PERMIT FEE -
<br />,_.. _. .. _..t..„: ..._
<br />� �. : ;(i.�. . _._. _. _. . TOTAL SEWER PERMIT FEES
<br />�L
<br />�. .. .... .
<br />� �.is (7� MONTHLY,SEWER CHARGES: _ .
<br />, ,%�!' : ' ; SEWER CONSTRUCTION TRUCK
<br />w,.i . .. .�_..... _.,.. _ ..
<br />� � LATERAL
<br />f - � ,; ' .
<br />` �:.. I:,.•: �. �:...� _..SEWER SERVICE . �. .
<br />!"``APpROX. LOCATION�OF SIDE SEWER OR T�E IN THE MAIN: _
<br />;.�, �
<br />� ��?�: '_�... , . , . .
<br />�? . : � _
<br />�'� ,, �
<br />';. _ � .,
<br />,, ,
<br />' ;;' INFO COMPILED BY:
<br />; APPROVAL•
<br />� _ _ ..
<br />; :^1. � ,. ...
<br />-::.. _
<br />.... ,_��. .:;.- -� -
<br />ner ' ,
<br />.
<br />E ._ •
<br />_ CHART �
<br />DATE
<br />DATE
<br />
|