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DEMRTMENT OF COMMUNITY DEVELO►MFNT SERVICES <br />BU�LDING PERMIT INF�RMATION <br />ADDRESS �Zo7 ,d-O �rzp,uo Qu� __ TYPE L u � <br />(1) BUILDING PERMIT FEE �IOO�O�D• � E 3• p7� <br />(A) PLAN CHECK FEE - <br />(2) PLUMBINC <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 G"�,oi,�-/ CP.�.ec� 2D ��_ <br />s2 . oa <br />�'J� . S� � <br />5ao. �l1 <br />�f `1� D��CHART G`30-Z4-S <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE FEET DRIVEWAY(TYPE) 3 Z�'�D <br />S <br />(7) STATUS OF SEWER CHARGE�: <br />BOND _ DISTRICT FOOTAGE �'��tt.�- �.J�o <br />NOTES <br />�S <br />��9G�.4�li �l�'w�i '�� <br />Gb.t2,t� //7/-8y <br />F�?,� �(v- ao <br />5��` Q=e-d <br />�1��✓`' � <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRIiNK <br />LATERAL <br />TOTI�L CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />SEWER SERVICE <br />f <br />S <br />S 3p.�a <br />S 3o.ea <br />TRUCK S <br />LATERAL <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: _�'. <br />- - -•. ._.. _ <br />lx�Lr i - [l''o �►..ri�v+c i�-� i - - - - - <br />5 �T. P- CHART �-'-K`�-Zy-e <br />�E-�b�Z TD fbE A Ma,i.I BF Lv' ���u O�/Jx�[c �;G f'JL�BM ���es <br />iN�O M/��'— <br />OCOfvSPIIEi� BY: �.__� UATL- <br />A,PPFiOVAL: <br />5-84 <br />_ DATE <br />