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,', <br /> �,`�''� '� <br /> � �� <br /> , BUILDING PERMIT INFORMATION <br /> ,. .,- . <br /> ' 11DDRESS � 1� �ls1..Ir�_ �1,}� TYPE �� <br /> (1) BUILDING PERMIT FEE "j O�e�1Q -� b s�,.sp '� <br /> • (A) PLAN CHECK FEE _�'a.,.�'� <br /> (2) PLUMBING a{rj- C9�� <br /> (3) MECHANICAL -7a� <br /> (4) WATER SERVICE TO HE PnID PRIOR 1�0 BUILDING PERMIT ISSUANCE eO .� <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR �� INCH <br /> ;; (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> . (C) APPROX. LOCATION <br /> CHART <br /> .a (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> , ;,.. SUANCE FEET - DRIVEWAY(TYFE) b _. 2� �C� <br /> " b <br /> j; p) STATUS OF SEWER CHARGES: , Iry�pO <br /> �)BOND _� DISTRICT F� F�a � ��_ RTqN, <br /> "'' - �)I /��, � �� „ESBA <br /> NOTES oF '�c t� � p,aTE7 � <br /> PH�NE <br /> ��En <br /> ' c'�-1 AI.. l.l"R411`t �� �;'ESSACF r= e ,� q - <br /> ''i o� ��-tt- g 5^ � << ^ ��- �� �C�� �kTEN�v <br /> s Im <br /> ' W�,�O l Z9 , e9 O v �� /Z ti <br /> i <br /> '�� 5�3U� L�.Z� . 0 O _ S�^'Eo <br /> �"�"�S -et� <br /> • SEWER CONNECTION CHARGE� T� <br /> YEAR �7 TRUNK 5 Z�U ' �v <br /> � LATERAL ��0 . <br /> . ' +� TOTAL CONNECTION CHARGfS 5 ,7-�• � � <br /> ', ' <br /> ��� SEWER PERMIT fEE 5 �� •OO <br /> �; . CATCH BASIN PERMIT FEE '--" <br /> TOTAL SEWER PERMIT FEES 3 _ �1 .DZ� <br /> , � p) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK E <br /> •; LATERAL <br /> � SEWER SERVICE <br /> • APPRCX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: S'�C.Y� 't0 pfL. f�PP <br /> .�.w ��� � LoY 1z;�P�� d.� ��� <br /> . . , <br /> CHART `-�'35-Z�I�d <br /> � INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> i <br /> { � <br /> ; <br /> . • s�ea <br /> •� <br />