Laserfiche WebLink
L <br />, ENGINEERING Lf•.P:qtifldENT <br />�Z�p ��.,,f��P1UILDING PERMIT INi'OR7+U�TION <br />ADURESS_ � n d — / � � / Y' `"' ��, �L,TYPE v �� <br />1) BUILDING PERMIT FEE �Z �/¢�?� °� ' $ /��, BU <br />� (A) PL11N CHECK FEE S r 7. -�� <br />2) YihTER SERVICE TO B� PAID BEI'ORE BUI:.DING �+ /�f t'`/ • 4, '� <br />PERMIT IS IESUED �j+`,�� �� �"�$ 'VL��•�� <br />� �' � �/�v Yc.P�a, �-�. �u <br />(A) TO BE DETER:dINED BF PLBG. INSPa � INCH r���-t.,� �o .�� <br />(B) EXIST. WATER SERVICE� APPL. N0. ( u47 `f <br />. . (C) APPROXe L�CATION !� �7 G!J 9p� �C,� � <br />GD/Z. L Or � CHAF.T �j'/� <br />3) D3iVE�•:AY PERMIT TO BE-PAID �EFORE BUILDING <br />PER^1IT IS ISSUED 2� FT. ,�'`F�P/3A(.7 D/4? (TYPE) $ � Z•�''� <br />. .. � , — <br />��,% �,� y TOTAL* $ <br />9) S.^yTUS OF SEi+7ER CHARGES: �''' <br />� B0:2D DISTRICT FOOTAGE �i%"I�%ti+'U", <br />N. •S, E, W. <br />SEWER CONSTRUCTTONe <br />SEWER CO.:NECTION CEiARGES : <br />XEAR � TRUNK <br />I,ATERAL <br />TOTAI� CONNECTION CHhP.GE <br />SEWER PERMIT FE� <br />CbTCH i3ASIN PERMIT FEE <br />;� <br />$ <br />S .3D• �'� <br />S <br />� � � E�, <br />'.P01'AL SES�TER YEFI�iI2` FEES �� $_. .J _/ <br />�J - <br />�� . � <br />TRUNK ��i'��� $ <br />LATERAL ✓`� $ <br />SEWER SERVICEa <br />APPRJ\. T�OCA'PION OF SIDE SE�tiTER OR TcE YN THE MAIN: <br />INFO �0>:PILED BY: <br />REVIE�i: <br />PROJBCTS �IVISION <br />APPROCaL: <br />ENGIN�ERING DI3PARTMENT <br />S <br />�i�iG� . �Lb r_-- <br />C��u/E: �k: <br />/` / � / V. ..) <br />J <br />DATE <br />DATE <br />DATE <br />