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�. <br />� ��OPMENT SERVICES <br />UVILI�r. ..� - .-������ � R���1fORN'.,ATION <br />ADDRE55 <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />( � �� EY�d - °c' <br />TYPE � u'v�� �T <br />g SL`��. �O <br />PO . � � �3r�% <br />g ¢ . c.�t� <br />2 �- so <br />�"G'c�J. DO <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDlNG PERMIT ISSUANCE -� <br />(A) TO B[ D[TFRMINED 8Y E3LDG INSPECTOR � INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. _. <br />(C) APPROX.LOCATION ���'`"�'4r� 'a`PP''�K �'�F7 <br />� D�� ��`AT�CHART .0-?'I'Z9'-S _ <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PLRMIT IS- rO <br />SUANCE FEET DFIV[WAY(TYPE) S _� <br />S <br />(7) STATUS OF SEWER CHARGES: ,��'D�Y�_��� <br />BOND DISTRICT _ FOOTAGE — <br />N, S, E, W <br />NOT[S <br />�J�l�'� Z�-ZJ. �-� <br />���� //7/- ��� <br />� � � i 5 = � �u'Q-��� <br />� x 3v3 = 21�-1 �,s�.susc_.-t2� <br />� 2�.2 to . a� <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMII' FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLI' SEWER CHARGES: <br />SEWER CONSTRUCI�ION TRUCK <br />LATERAL <br />S <br />S <br />g _ �D. DC� <br />3 <br />SEWER SERVICE � �JY , <br />APPROX. LOCATION OF SiDE SEWER OR TEE IN THE MAIN: ���'� �-� <br />' s � 8' �� ,e�s�� "``� d 4 r=r' v�� <br />_rrnii, v"i P�� ' ,d-31-Z4 -s <br />�� <br />M ll �� �-� �� 5' CHART <br />INFO COMPILED dY: <br />APPROVAL: <br />5 �4 <br />DATE <br />DATE <br />