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r <br /> /'� <br /> DE�A�TMENT OF COMMUNITY DEVELOIMENT SERVICES <br /> BUILDING PF.RMIT INFORMATIC)N. <br /> r <br /> ADDRE55 0? 7��- II e � . 1 t /{'vt'��-�-r. TYPE <br /> (1) BUILDINC PERMIT FEE �, _ s <br /> (A) PLAN CHECK FEE %�o � c'-�'�u`�'t�%O D �� �`�r.' 2 S.a 3 <br /> (2) PLUMBING }7J�` <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE. APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) S <br /> S � <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND DISTRICT _ FOOTAGE <br /> ; <br /> N, 5, E, W • : <br /> �', �� <br /> ; ��:. .'-_•:• : <br /> NOTES �' }'=' <br /> �V <br /> SEWER CONNECTION CHARGES <br /> YE/1R TRUNK f <br /> LATERAL <br /> TOTAL CONNECTION CHARGES S <br /> SEWER PERMIT FEE f <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES S <br /> (7) MONTHLY SEWER CHARCES: <br /> SEWER CONSTRUCTION TRUCK S <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART <br /> L INFO COMPILED BY: DATE <br /> APPROVAL: D11TE <br /> 91�79 <br /> L <br />