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\ <br /> � � � <br /> �l!lL,D91Vta PERMI� �tdF�DRMlAT90P1 <br /> ADDRESS — -: Go2O �tlq/� .S�'f"' � �,,� <br /> � � (1) BUILDING PERMIT FEE � --``r'�"'�'��— <br /> �a <br /> 10 C <br /> (A) PLAN CHECK FEE �`�(`Z� <br /> � y�E N (2) PLUMBING _ ___. <br /> H q H I � <br /> ,� z � (3) MECHANICAL I�-l�' � i'� <br /> H Sb � " <br /> ro y � (4) STATESURCF�ARGES i� `' I �� � �y�� <br /> � z (A) BUILDING:ODE <br /> �,F�,S� <br /> o y � (6) ENERGYCODE J•�:I-;',� c,:; ` 1,!�,Ni — I <br /> :a:i;iv�_ir: I I`.: I <br /> � � � (5) DRluEWAY PERMIT -- <br /> z � � -��" � il <br /> H <br /> H H <br /> � � �' (6) WATER SERVICE TO BE PAID PRIOR TO BUIIDING PERMIT ISSU�INCE� 5 7 yG� � <br /> g � � ' / ri r,�(.>i�l� . " ._ cr <br /> z y y (A) TO BE DETERMINED BY BLDG. INSPECTOR___� �NCH �D r ;� �C �,j,��`� <br /> H O N I <br /> (B) EXIST. _WATER SERVICE APPUCATION NO. <br /> (7) STATUS OF SEWE�j CHARGES: � <br /> BOND._�� ���y+_ DISTRICT FOOTAGE_ <br /> N, S, E. W <br /> �c. ORDINANCE 1171-85 � <br /> ��`f . ��l ,) = � �, �'�'Z� WATER —�C'�3(J S� � <br /> SE'NER "�� ���'� �� <br /> TOTAL ORD. FEE ''`—�'-�'�'��i <br /> T— <br /> : �� <br /> f � �� � <br /> SEWER CONNECTION CHARGES I <br /> � YEAR __ TRUNK S 6"� ���� <br /> � '� LATERAL <br /> m ITOTAL CONNECTION CHAnGES S <br /> �...e � aG � <br /> ' �e� SEWER PERMIT FEE S - —=� � <br /> CV <br /> �� �L� �1�GIr� �' '� � �� <br /> � <br /> � � 0 � - � ` <br /> a... � <br /> II �� � <br /> � �.,�I I <br /> � <br /> I <br />