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� � k� � <br /> BUILDING PERMIT INFORMATION <br /> �" � <br /> A� x . . <br /> C H ' <br /> 9 H V� <br /> ' �y ADDRESS <br /> K y � (1) BUILDING PERMIT FEE sa..S-CCI �7 C�zQ� S�( • Qa $q _a3� °� <br /> �H� (A) PLANCHECKFEE 53 �0•�, �cP I�Q�,(7, �N�I� S�DI�/ Z�Z — <br /> �z� (2) PLUMBING l��I� <br /> � b (3) MECHANICAL /`/° � <br /> � � g (4) STATE SURCHARGES <br /> �� � (A) 13UILDING CODE v�� �� �'��"' � � �G <br /> �y� (B) ENERGY CODE t�, t t <br /> ' y (5) DRIVEWAY PERMIT � +rH=+�'Z�� _" rrQ <br /> gy <br /> d � � . - � 4�t �,sg" <br /> �y � (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ I�G pG <br /> (A) TO BE DETERMINED BY BLDG. INSPECTOR � i INCH <br /> (B) EXIST. WATER SERVICE APPLICATION NO. <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND__(^� DISTRICT FOOTAGE <br /> N, S, E, W <br /> C��"- ORDINANCE 1171-85 <br /> S - �JS-c2�1 "`I WATER �Zo2`I oc <br /> SEWER ✓rcF 9 �`� <br /> '.�' TOTAL ORD. FEE c�I.3 � <br /> ��� <br /> SEWER CONNECTION CHARGES <br /> I I YEAR TRUNK S c27D� <br /> ��I LATERAL — <br /> � <br /> 1 TOTAL CONNECTION CHARGES S ,� 7D <br /> ' SEWER PERMIT FEE 9 �a � <br /> � � <br /> ��� �� <br /> �.�. A ,� _. ..„-�_ <br /> �. ,� � � � � �- � <br /> '�; .. ° . . �A.�.. . .. . . . . <br /> h� jjj,,, t <br /> -�x}- �� �} ' { �� * �i '�n^, . - . <br /> � "' y�. � �r�. �ro � �n.�.a . <br /> 1 � x } <br /> � x.:.. .at�✓�' ' �'�1 . <br /> — .ys�.�., t 4�Y�t « y .�.Ipva�M 4 . . . <br /> y <br /> .� + ti �,��µ . <br /> �� 1 .:h F {�6 eA -w Y'' 1 ._ .y$1�r . . <br /> �� ' i { Sh a �. r�`h N . ( . . <br /> .q �n r� i <br /> .._ .. �,�y��. frk�! n~y . <br /> se #�.y':'""_ts;£`"� ��,�, i , ',xi + ��M�'� � , �^� . <br /> �,:,.:..:_ b��.,c:.:�. :rt.i�... . . .. �..:a . . . <br /> f� �.. � � <br /> s� �"��:'• j{ t � ; .r � � . . . � <br /> �i, . .... 3 �-5,.:-�t � . �, ' . , . <br /> . �...;.:: .- . q t' .. � . . <br /> ;i�,. .. £ �r �. � . . . <br /> " iix,..� .'� ' � . � . . . <br /> w � Y. .. . '� Y � 1i`v g'i.. .. .. . . .. <br /> _ <br /> � , .y -4i.t. <br /> : ,},+� - <br /> f� ...&��"� � {� ., . r� '�e"..��� �r � . . ' . _ '''n'S`,':'�: I <br />