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BUIL.DING PERMIT INFORMATION <br /> ADDRESS <br /> (1) BUILDING PERMIT FEE � <br /> (A) PLAN CHECK FEE <br /> ��� (2) PLUMBING <br /> ��x (3) MECHANICAL <br /> a y y (4) STATE SURCHARGES <br /> � �� (A) BUILDING CODE <br /> "� y� (B) ENERGY CODE <br /> y y� (5) DRIVEWAY PERMIT <br /> S �3 ' � - <br /> � HC <br /> � Ca g (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PEF�MIT ISSUANCE S _.____�:1�' � I�r' <br /> G�,. o �� �,. <br /> � H� (A) TO BE DETERMINED BY BLDG. INSPECTOR___`I_ _ INCH <br /> Hy (B) EXIST._ WATER SERVICE APPLICATION NO. <br /> g � (7) STATUS OF S�ER CHARGES: <br /> H <br /> � d v' BOND �� DISTRICT _ FOOTAGE <br /> � �� N. S. E. \;' <br /> HOC�/� <br /> ORDINANCE 1171•85 / <br /> WATER _�a`1_`J.�_ __ --- <br /> SEV��ER —�p9 �'� - <br /> TOTAL ORD. FEE �'i3=0v <br /> I �'j <br /> SEWER CONNECTION CHARGES <br /> YEAR - --- _ TRUNK S �7J _,I �- - <br /> (�,,, .�t _-- <br /> "�� LATERAL - <br /> TOTAL CONNECTION CHARGES 9 .� �O• 0 0 <br /> �� �� <br /> v� I <br /> �SEWER PERMIT FEE S _ _ _ _ _��->> --- <br /> �� , <br /> I� `� <br /> .,,.� 1 <br /> i�l 1 <br /> �, /, , <br /> ���7�F-( c�a0 �J /� 3 � ;,_- <br /> C) p <br /> I�oG�- 3aC� 3lcv � <br /> ! c�-`_ � /%� 3G,C � <br /> /:�,���:r��; _ i <br /> � � � , <br /> ; <br />