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QI <br /> fy <br /> I <br /> DFPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br /> BUILDIN� PERMIT INF9�6tMATION <br /> _.ti <br /> a� ��'� + <br /> ADDRE55 ` �- /� L=�=��T�� ��C—. TYPf: _ � �� <br /> (1) BUILDING PERMIT FFE �-"3 �' ��'�� $ —`��`�, O � <br /> (A) PLAN CHECK FEE P'U� �� �c��G �� <br /> :7(v. cU U <br /> (7.) PLUMBING <br /> (3) MECHANICAL - � ���— <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISS'JANCE _ �6 O, OL' <br /> (A) TO BE DETERMINED BY 4LDG INSPECTOR 3 �� _ lNCH ..L , � �; : � ���� <br /> (B) EXIST. _ WATER SERVICE, APPLICATION NO. _ <br /> (C1 APPROX. LOCATION <br /> CHART <br /> (Si DRIVEWAY PERMIT TO f3E PAID PRIOR TO BUILDING PERMIT IS- � � �jC� <br /> SUANf_E FEET DRIVEWAY(TYPE) $ _`' <br /> $ <br /> (7) STATU$ OF SEWER CNARG�S: <br /> BOND � DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> ��1n/� t�cv�LEpMuv7 �"� <br /> O.e.o 722 -8 � <br /> A��-n 2 <br /> sr'2 ���9- �"' <br /> SEWER CONNECTION CH�RGES <br /> YEAR �� TRUNK � � �U' ��� <br /> LATERAL a��� 7�, 33'" � � �1730 <br /> TOTAL CONNECTION CHARGF.S $ �-' �' `�C <br /> SEWER PERIJiII" FEE $ '3�� �� <br /> ______--- <br /> CATCH BASIN PER1v11T FEE <br /> 3C>-c�7C� <br /> TOTAL SEWER PERMIT FEES $ _ <br /> (7) MONTHLY SEWER CHARGES: � <br /> SE\NER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> � APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART <br /> INFOCOMPILEDBY: . DATE — .�b <br /> APPROVAL: DA7E <br /> 91J9 <br />