Laserfiche WebLink
� <br /> . . BUILDING PERVIIT I\FOR�IATION � <br /> � �� �7 n <br /> ADDRESS J �S �� / �` vF�l"�'/i' �`, �'�F • -7 — <br /> �i�r� /i � " n-? ; "-� ' 1:!;�i7 f�� DAT� /-��7.1 <br /> TYPE OF BUILDING :�-� 1 (�,, r� t", , , , ,: _ <br /> 1) BUILDL�IG PE Rh:I1' FEE �-�� �` �� �� <br /> (A) PL ;I CHECF{ FEE � < <�"�L" <br /> 21 �1:�TER SERVICE TO BE PAID BEFORE PUILDING g1;J S,l: c :� <br /> PER\IIT IS ISSUED <br /> (A) TO BE DETER�4IN�D BY PLBG. INSP. � � INCH <br /> (B) EYIST. 2 ,�� II �'�ATER SERVICE, APPL. NO. � `! 9:� <br /> (C) LOCATION �.1� fiU J £ �L �-� C �?7�� /�-t c.'��; =`- - <br /> 7�,�� Si i�:[ £ .Sti tJty 2 � L1 suN�t�r :� ,✓a �� •� cc4 7cc+ <br /> � v Aii:•1 whEGti .ve .:. 4n � d�a, /� !'roi'a�Ed Cf-LART Z3 •'V - <br /> S) DRIV��1`AY PER�IIT TO BE PAID BEFORL BUILDING z�� ,,`� <br /> PLR\IIT IS ISS�JED FT. D/«' (TYF'�) S <br /> ?a ' q.�✓'.(9�- 1' A�u' �S ��' .:. .`� �� <br /> . Z TOTALr: S ' � � <br /> -}) STATliS GF SE\\'ER CHARGES: <br /> BOND DISTRICT FOOTAGF. <br /> N�rr� EN� v, �; E, ��. <br /> L.�\DSC�PE NGTES SE1\*ER CONNECTLCN CI-L4RGE5: � <br /> — TF2UNK $ �� _ <br /> LATERAL S � <br /> TOTAL CC;VN�CTIO.I CFiARGE $ �- <br /> SE�VER PERMIT FEE 5 '�'a�'•U �r)0 <br /> CATCH BASI\ PEFVII'I' FEE S /(1 • [l C1 <br /> TOTAL SE�VEi2 PER1�fIT FEES $_ ;C%• �� Q <br /> 5) MONTHLY SE�VER CHARGES: + • <br /> SE�VER CONSTRJGTION: <br /> TRUNK $ --- _ <br /> ' LATERAL $ �� <br /> � v , )-L� <br /> SEtYER SERVICE: <br /> LOCATIO�: OF SIDE SEWER OR TEE IN THE MAIN: CHART V`2 � " Z 1- � 4 � <br /> S � � � t• � �� � ,. ,v� 5" 2 L� � � F , y. <br /> Jl/ C'`= -v �`2 Cn C ,�J '_Lti �1 � ( C � s'i fF ,S °,.�e'f7 �e{�ilr�sd <br /> INFO CO\IPILED BY: r1�,; � ,�/ DAT�_ 7- ��' - 7� <br /> � �� <br /> REVIEN: � � DATE � <br /> TRAFFIG DiVISION <br /> APPROVAL: � DATE �� %� <br /> i GINEERI G DEPARTMENT � <br /> � <br /> i <br /> This total z:ust be paid before Uuilding permit is i::sued. � <br /> - o . <br /> • � _ <br />