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; _. <br />DEMRTMENT OF COMMUNITY DEVELO�MENT SERYICES <br />BUILDING PERMIT INFORMATIO(� <br />ADDRESS lQ�l �9 a�a /��rg,�.�-�y� TYPE�up�-�-"'1L <br />(1) BUILDINC PERMIT FEE � �2,[�`Cb'�� 3�"P• ��'-'L���o <br />(A) PLAN CHECK FEE `�rla.�os���,�_�-� <br />(2) PLUMBINC 3(p • O Z� <br />(3} MECHANICAL Z7• �v <br />(4j WATER SERVICE TO BE PAID PRIOR TO BUILDINC PERMIT ISSUANCE S`00- �v <br />(A) TO BE DETERMINED BY BLOC INSPECTOR � INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOGTION � � �� �� At'P/G�x 15 � �% UJ <br />�F d'" o� "7� CHART Y-�-ZS-S' <br />(5) DRIVEWAY PERMIT TO Bf PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE <br />FEET <br />(7) STATUS OF SEWER CHARGES: <br />BOND � DISTRICT <br />NOTES <br />��UC� '���1- �� <br />4�-0 !/7/-gs� <br />f-lZ O 2ivf:�%� <br />�ZvE72 f�� a <br />� �-� <br />DRIVEWAY(TYPE) 5 20•OO <br />5 9 3�t. �s <br />FOOTAGE �`-' <br />N, S, E, V1' <br />�Z .� <br />2�st� <br />SEWER CONNECTION CHARGES <br />YEAR ��'� TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />S nA c n , <br />y ��•ei <br />a 3p - <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK S �'�`r��'� <br />LATERAL � � <br />SEWER SERVICE " <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: 9��n�� � � <br />���v ' �,o-r Tv PI� nna2ox f7� rs-r � D� M.�J. 7 <br />n <br />INFO COMPILED BY: <br />APPROVAL: <br />5•84 <br />CHART Y-�-��'-� <br />DATE <br />DATE <br />