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i <br /> ,F' <br /> . � � <br /> . � � DEPARTMENT UF COMMUNlTY DEVELOPM�FIT SERVICES <br /> � BUILDING PERMIT INFORMAl�ION <br /> �,, <br /> . <br /> q � <br /> ADDRESS � <br /> �3 6� � �•�c-�-- �G-�- TYPE J,�,E'. <br /> (1) BUILDING PERMIT FEE `��C,�Y9C�. U`� <br /> $ 2?���.[�L <br /> (A) PLAN CHECK FEE � � ��/��, <br /> �Z,1.. v v <br /> (iJ PLUME3ING <br /> (3) Iv1F�'HANICAL '��'�� <br /> (4) �NATER SERVICE TO BE PAID PRIOR T(� BUILDING P[RMIT ISSUANCE ¢�»'pU <br /> � INCH ��s�s' <br /> (A) TO E3E DETERMIN[D OY BLDG INSPECTOR _�Q.— <br /> (B) EXIST. __ WATER SERVICE, APPLICATION �O. -- <br /> (C? APPROX. LOCHTION <br /> CHART <br /> (5) DRIVEWAY PERh11T TO BE P�ID PRIOR TO l3UILDING PERMIT IS- � �, p� <br /> SUANCE FEET DRIVEWAY (TY�E) � � -;,o � � <br /> S — <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND � DISTRICT __ FOOTAGE <br /> N, 5, E, W <br /> NOTES <br /> ,`�l,vC-� 17o�/c"Z.�F�ME�7 �CL= <br /> �2/� 722`P�� <br /> ,�.f� 2 <br /> �f-,� �33r_c�v <br /> �`ofy>3 � <br /> SEWER CONN[CTION CH�RGES <br /> YEAR �� TRUNK $ �3``�•�C> <br /> LA7ERAL '�(a32�9-6 <br /> TOTAL CONNECTION CHARGES $ `�30�� D <br /> ray73/ <br /> SEWER PERMIT FEE $ 3�• �v <br /> CATCFi BASIN PERMIT FEE <br /> TOTAL SFWER PERh11T FEES $ ��"�� <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> � APPROX. LOCATION C� SIDE SEWEft OR TEE IN THE MAIN: <br /> CHART <br /> INFO COMPILED BY: <br /> DATE -� <br /> DATE <br /> APPROVAL: <br /> 9-1 79 <br />