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9 '�1 <br /> .I ` : <br /> V <br /> �i BUILDfNG PERMiT INFORMATI(�N <br /> ':i <br /> ' �J�LG(G50 `7T TYPE ��� `� <br /> !� ADDRE55 �� `� $ g��. (`j ��_ <br /> ;4 (11 BUILDING PERMIT fEE ,����' c�.8��t7 _ <br /> ; (A) PLAN CHECK FEE ��, pd <br /> � (�; PLUMBING 2[� .OQ <br /> `.� (3) MECHANICAL �QO.OU <br /> ,� (4'� WATER SERVICE TO BE PAID PRIOR TO BUILDING PERM� ISSUANCH <br /> (A) TO BE DE�TERMINED BY BLDG INSPECTOR ��-- <br /> ' (B) EXIST. WATER SERVS�E, APP�.ICATION NO. <br /> �� ��� a ,� n,va2 or t D �r f� 6F' <br /> (C1 APPROX. LOCATION <br /> `i , <br /> "� � d�- .� CHART J—==�' - � , <br /> �� (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- 2� ,O U � <br /> '� SUANCE FEET DRI�/EWAY (TYPE) S <br /> S , <br /> rj <br /> � (7) STATUS OF SEWER CHARGES: FOOTAGE <br /> ' BOND — �-DISTRICT <br /> i'� '�• �'� E� bV <br /> � <br /> -`� NOTES <br /> `i ���,L GfT/L�� l/�,t-�y� <br /> 'i o,�o �n�-�", s <br /> ' �.a (� ��z ��° <br /> 2 <br /> � pC�. <br /> ;; �✓� `�2 „QJ <br /> �� <br /> �; SEWER CONNECTION CHARGES ���, 0 0 <br /> �� YEAR � � TRUNK $ <br /> LATERAL ��D� �U <br /> i.� TOTAL CONNECTION CIiARGES $ ��''� ��� <br /> ;� � � D v <br /> �? $E����. PERMIT FEE __ <br /> Ui _._ <br /> ;! CATCH BASIN PERMIT FEE <br /> � $ 30-4 v <br /> ;� TOTAL SEWER PERMIT FEES <br /> �:� <br /> i� (7) MGNTHLY SEWER CHARGES: $ <br /> ,� SEWER CONSTRUCTION TRUCK <br /> ,p LATERAL <br /> `;; SEWER SERVICE <br /> ;� ¢3'' M A !lJ A,r�P/> O x. <br /> APPROX. LOCATION OF SIDE SE�E'R JOR �E IN `THE MAIN: � !`J <br /> , S ��s U� F�8 -�8 - 5� <br /> ,' CHART ---- <br /> '� <br /> �;�{ <br /> DA7E <br /> INFO COMPILED 8Y: DATE <br /> APPROVAL: <br /> ; <br /> s�ea <br />