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� <br /> � r:� <br /> BUILDING PERMIT INFQRM�A710N� <br /> ADDRESS -'� <br /> (1) BUILDING PERMIT FEE $ ��� �— <br /> (A) PLAN CHECK FEE .- <br /> (2) PLUMBING � <br /> (3) MECHANICAL <br /> (4) STATF SURCHARGE� L� � <br /> � ��C (A) BUILDING CODE <br /> � �'� (B) ENERGY CODE r,— <br /> � [n (5) DRIVEWAY PERMIT c—�— <br /> � � � �1��(�-� <br /> H H <br /> Ox0 '^ � <br /> `� y H (o) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT I UANCE S -k�'� <br /> � � � (A) TO BE DETERMINED BY BLDG. INSPECTOR �L� INCH <br /> O i..� (B) EXIST. WATER SERVICE APPLICATION NO. <br /> p� g (7) STATUS OF SEWER CHARGES: <br /> a y� BOND���DISTRICT __— FOOTAGE N, S, E w <br /> t� <br /> HH <br /> �b y ORDINANCE 1171-85 1 — <br /> � � � WATER �"�`i <br /> y � y SEWER `r-��� <br /> TOTAL ORD. FEE �L-�' <br /> � SEWER CONNECTION CHARGES � <br /> ' �?�1�� <br /> I �� YEAR— —TRUNK S _ <br /> LATERAL <br /> TO7AL CONNECTIOIJ CHARGES S ��� <br /> � �� SEWER PERMIT FEE � ���� <br /> ���� <br /> I ���_� <br /> ���. <br />