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I'U!� C I'L'�.' U:J1; p,1f,Y - <br /> L•'NGINLL:RING AiID COi!;QUP1I'PY SliRVICES � <br /> IIUILDING PI:RIdI'P INI'OP.PLITION <br /> nUDRESS I9FJ 7 �"fl��'T �L/G. TYPE �Q/t///L�I <br /> 1) BUILUING P�It:7IT FEE 90i�'�• � $ 2 ��' � O <br /> (A) PL71t7 C[I�CK FEG $ ��'�" S� <br /> 2) PLUMI3ING . $ IS� dO <br /> s) ri�c►1��Nzcr� <br /> $ I�.J . r <br /> 4) ?'7ATER SERVICr TO IIE PAID BEFORE BUILDING � � �"-- <br /> P�RAIIT IS ISSUBD � ��i���$ "��� <br /> � <br /> (A) TO. IIE D�TERAlIN�D BY PLBG. INSP. > f INCft <br /> (R1 �XIST. • I'7ATL•'R S�RVICE, APnL. NO. <br /> (C) APPROX. LOCATION ��� C•1 G�L L�PO.eO�c �3F.T � �F <br /> � �.(� ( /�tlE CHART I�I� ZC� <br /> 5) DRIVEj9AY PERtfIT TO II� P11ID DEFOR� IIUILDING <br /> P�R?SIT IS ISSUED FT. D/�4 (TYPG) $ - <br /> 6) STATUS OF SEr��R CHARGES: TOT1\L $ 4� 0 •S 5� <br /> • BOND DISTRICT FOOT1\GE /�/�H�'i0 <br /> N, S, E� �'l. <br /> �b'��P <br /> �� SEP]ER CONN�CTION CfIARGGS <br /> NOTES <br /> � �. �' ' , . " � . . .. YL:11R TRUV C $_ <br /> �t, �'r : y'., � . <br /> U%/U7't( �1L1�lh�y �'l�r�- '" LATERI�L $ <br /> TD I�� �-�' � ' r� �r �•J � TOT11L CONtdECTION CFIARGE$ <br /> i � N <br /> �." : :.:r . : dd. 7/a//7j . ; ,v6s p <br /> SE";ER PiiiZ�4IT PEE $ ��• �" <br /> J�ai��� �`� �--� <br /> CATCH IIASIN P�RItIT P�E $ <br /> /- /3- O S5�- oo -�.j p , m '' <br /> TOTAL SES'?�R P�RidIT FE�S$ <br /> 7) "lONTHLY SEI'I�R CHARGliS : <br /> SG!9�R COtdSTR[3CTION: TRUNK $ �� <br /> LAT�RAL $ <br /> SP•.WP•,R SBRVICE S���r� <br /> I�PPP.O:{. LOC�ITION Or SIDE �E`JER OR TP� IN TIIE h1ATN: ���/v/,J/�-� � O�' QLs-��'-,� <br /> tT,r� /A/ �fl/J i M /�F�d 20K �a F T f� . OF M I-1--� !z o�v.-,.. 1 1 �T� DE3--n _ <br /> ►�C.So �l�Pec?� IE�f�rY N a� ,<.'iF�i__�D:.:FTF-t fiPPROx CISART V— 20-Z9-5 _ <br /> -i'�L�:L-y.� 11 � IZF-r �'-�' <br /> r:�r0 C0.�IP.iLED BY: _ _. �A'rL — — <br /> t`,^I'1'•,OV!\L: n1\'PI? _�_. <br /> � <br />