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_ _ .,,. <br /> � - . . <br /> DE►ARTMENT Of COMMUNITY DEVELO�MENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> ���pr� �lT, TYPE Gl1� �a <br /> ADDRE55 �LF � <br /> (1) BUILDING PERMIT FEE � �� 76U� 6bO'O� S p� ��� <br /> (A) PL/1N CHECK FEE 2/g,BO <br /> (2) PLUMBINC <br /> (3) MECH1INICAL ' ���� �� <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> Z <br /> 0 <br /> CHART � <br /> c� <br /> (5) DRIVEWAY PERMIT TO BE P/11D PRIOR TO BUILDING PERMIT IS- 2. S� !" <br /> SUANCE � FEET 7' '����"f DRIVEW/1Y(TYPE) S � � � <br /> S .. -, <br /> N 2 <br /> m <br /> 0 <br /> (7) $TATUS OF $EWER CHARGES: m� <br /> BOND DISTRICT FOOTAGE o 3 <br /> N, 5, E, W = � <br /> m <br /> NOTES. o z <br /> c <br /> a -+ <br /> rx <br /> .. .. <br /> Sau�—�. 'D�V�.E.�MUVr � N <br /> ��' -n <br /> M/�� -�7 �! O A <br /> lY�iF/ L! V'� S� --I 13.1 <br /> AE6� �- _ <br /> m .+ <br /> N <br /> v <br /> crsuecN - _ �/43d,..Jv9 <br /> SO.l�d9� �C •� '928E' . • m � <br /> ` z c� <br /> '� SEWER CONNECTION CHARGES � m <br /> a <br /> �I��I� YEAR TRUNK S � <br /> _ <br /> LATERAL Z <br /> TOTAL CONNECTION CHARGES S = <br /> ,.. <br /> � <br /> SEWER PERMIT FEE � S ;� o <br /> CATCH BASIN PERMIT FEE� � / CO• 0 0 ,;; <br /> TOTAL SfWER PERMIT FEES�� � SI S /3d.00 <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK s <br /> LATERAL <br /> SEWER SERVICE � `��� <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART �-2� � �q -�' <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> 41•79 ' <br />