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�,Yu� 2 . <br />4'' lo�.vs <br />�qro Lcql�- <br />DEPAR'��NENT OF COMMUNITY DEVELOPMENT SERVICES <br />BtJILDIf�G PERMIT INFORMATtON <br />TYPE � r O <br />ADDRESS .-�:n,-" % i1,�rN//�=�.�. P-n $ 2Y��( Uv <br />(1; BUILDING PERMIT FEE ��2. ��" `- <br />3�. Z L Ds t_E. <br />(A) PLAN CHECK FEE ij �-v v _ <br />(2) PLUMBINC 2� -���� <br />(3) MECHANICAL 2 ��� �U <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILUING PER�JMIT ISSUANCH �� �`"��� 5����L, <br />(A) TO BE DETERMINED BY BLDG INSPECTOR �¢-- <br />(8) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION <br />� �/J�O� A���K--��y"�- <br />OF.y " � ,� �M�CFiAKT � � `� <br />�2•�� <br />(5) DRIVEWAY PfRMiT TO BE PAID,PRIOR ^O YLDRIVEWAY(TYPE) S — <br />SUO.NCE � FEET e.�.�--.-�--�- $ �,� vj• � <br />(7) STATUS OF SEWER CHARGES: <br />BOND �T--DISTRICT � F��TAGR S E W <br />NOTES <br />S"Pl.�!!�C- 6i�t�t� GN�,1eyt_-s�/ <br />Z��-t-£SG <br />�� . � "` �-tr-r2 a �� /} <br />� � ¢� � p v <br />��� <br />�. � azr� — Y �� <br />--+'� - - �EWER CONNECTION CHARGES ,L.7Q UU <br />YEAR _ 8� TRUNK $ � <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEN'ER CHARGES: TRUCK <br />SEWER CONSTRUCTION LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />e ia� <br />$ 27E7. �c) <br />$ �� / �-✓-� <br />M7Ac i.J �� �� <br />n �� _: <br />CHART K- � "J - <br />DATE <br />DATE <br />