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..� <br />ENGIREERING DEPARTMENT <br />BUILDING PERMIT INFORMATION <br />AbDRE'.SS�_ '9% l8 � �y n,-t e we +a� ?i r. _ TYPE S� iP ' <br />/7'7. .OD <br />1) AUII,DING PERMIT FEE S -�iao <br />(A) PI.4N CHECK FEE $ A C_ �n <br />2) WATER SERVICE TO DE PAID 9EFORE BUILDING <br />?ER�IIT IS ISSUED S G.O, o n <br />(a; TO i�E DETERMINED BY PLBG. INSP. �_ INGH /�C-r�". �' i^. cL <br />%vIt r-F' 7 . c9.� <br />(iS) EXIST. WATER SERVICE, APPL. N0. , <br />(C) APPRO`C. LOCATION �� �/, of S. ��-3�.i:r+� o� sccc� <br />CHART IN -2 z <br />') :�:;_'.';'.��AY Pi;RMI2 TO BE PAID BEFORE BUILDING <br />P::.�:ii IS ISSUED 2y— FT. � D/W (TYPE) <br />TOTAL* <br />-1) ; :;.':: S OF SEA'ER CHARGES: <br />_�:..)_�_ DISTRICT /�' FOOTAGE -- <br />N, S, E, W. <br />3 -f 4 — Z �� z -o�� <br />� ----- -- yOTES <br />'�� S. S. i'lu� clU4r �a p�e •f-o <br />�r��e��l-� deS�ri bed, <br />1, . gcu�zr %, i'�� �u� -�-o K` N14iiL <br />(c� pfl�r�a.u:i�'s �>cp ec�se � <br />/ � <br />0 <br />�; ' _ . .. : 3i.hER C}iARGES: -- — <br />SEWER COhSTRUCTION: <br />SEWER SERVICE: <br />SEWER CO.TNECTION CHARGES: <br />YEAR �14 TRUNK <br />TOTA'L`CO�INECT'ION�C' l"�E <br />SE�'�%l�RM�T �'E�� <br />�/ �Qfl <br />CA C ASIN�PE IT FEE <br />TOTAL SEWER PERA;IT FEES <br />TRUNK <br />LATERAL <br />,:�:' '.' .. .';;:.TICV OF SIUE SEWER OR TEE IN THE MAIN: <br />-- ... � " r'1 a.i.a_. - ' <br />__ _%��'�ve.a��� ' � � CN <br />�::_•: : �• __'�.n BY: �`��' �--.�� ' <br />S �z.ra <br />S�� O• �o <br />5 "'_" <br />5 � 4S. ov <br />$ 30. O� <br />$ /.i� <br />$ � <br />$ 2 . S-a <br />> c c� " %eii f� <br />�iv.t, e> <br />- 3s-z9-9 <br />rE �/.�/�6 <br />� i;,.• : _ ,., ; DATE <br />�DIVISION <br />� ✓ /� <br />APP2 ..... . � - �*Tn �(� <br />✓ <br />