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` <br /> " � ENGINEERING DEPARTIQENT <br /> BUILDING PERMIT INFORMATION <br /> ', ADDRESS 2 ; / S C �4 n c� _ TYPE C e �.n rr� <br /> , <br /> 1) BUILDING PERMIT FEE �30� `�OC'7• �� $ �j'�j"� .(`X-� <br /> (A) PLAN CHECK FEE $_ ` ��,h <br /> 2) WATER SERVICE TO BE PAID BEFORE BUILDING <br /> PERMIT IS ISSUED $ <br /> (A) TO BE DETERMINED BY PLBG. INSP. INCH �p'G • ��'?' `� <br /> F�A.� <br /> (B) EXIST. Ce�.WATER SERVICE, APPL. N0. �p g <br /> (C) APPROX. LOCATION G �� ..�ar'n 33 � E pf g o7� �ron�r <br /> �d C CHART „^� <br /> 3) DRIV��9AY PERMIT TO BE PAID BEFORE BUILDING <br /> PERMIT IS ISSUED _ � FT. D/W (TYPE) $ <br /> TOTAL* $ Ls��jQ C�� <br /> 4) STATiJS OF SEWER CHARGES: <br /> BOND — DISTRICT - FOOTAGE N . Er <br /> N, S, E, W. <br /> NOTES SEWER CONNECTION CHARGc,S: <br /> YEAR '7c TRUNK $ <br /> , LATERAL $ "—' <br /> TOTAI, CONNECTION CHARGE $ <br /> SEWER PERMIT E'EE $ 30, 00 <br /> ee <br /> CATCH BASIN PERMIT FEE ��4 $ <br /> TOTAL SEYiER PERI�SIT FEES $ <br /> 5) DIONTHLY SSWER CHARGES: <br /> SEW�R CUNSTRUCTION: <br /> TRUNK $ <br /> LATF.RAL $ <br /> S�WER SERVICE: $ � p��•rR �/ <br /> APPRO:{. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: /B �� n�o;n - 7.? � C o l� <br /> � o'�" ,�j �o.�nl vP_ - •� 7- u 257 ' N. of E'. t'.N. �� i„t,�reat�'.n .� �' <br /> Cr +nd anr! 2S � CHART _� ( - Z <br /> INFO COMPILED BY: �fl�,;.,...-.� DATE�Iz _ <br /> REV I E�9: DATE <br /> PTtOJECTS DIVISIOPd <br /> APPROVAL: DATE <br /> ENGINEERING DEPARTMENT <br /> * This total must be paid before building permit is issued. <br />