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r <br />�4�� 4-`' <br />DEMRTMENT OF �OMMUNITY DEVELO�MENT SERVICES <br />BUILDING PERMIT INFORMATION <br />� <br />ADDRESS � 3a C%• � e7 .�filz�. i.�n-� �TYPE DuP���- <br />(1) BUILDING PERMIT FEE ���', 00� •�" 3 ��0�' °� <br />(A) PLAN CHECK FEE � 4���� p`�L <br />(2) PLUMBING � � U <br />(3) MECHANICAL <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDC INSPECTOR �. INC4 <br />(B) <br />(C) <br />3v.o0 <br />37� . �' C� <br />I `l� "f_'+zn4 <br />5 u P��� <br />EXIST. _— WATER SERVICE, APPLICATION NO. <br />APPROX. LOCATION �, G�-� �A�"� `�'"¢�"�` �� F� <br />�'!W '� _2 q , \� <br />�= e�=_ � ot� L��'Z��`'�CHART Y <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUIIDING PERMIT IS- � <br />SUANCE �� FEET � � �RIVEWAY(TYPE) S <br />fi"f= c.c-c>`-� s 8 sro. 8 S <br />(7) STATUS OF SEWER CHARGES: <br />BOND DISTRICT FOOTACE �!''r/�-� <br />NOTES <br />St�uCL �%JE�t7%/Ic�J �'� <br />�.�D L� (E Q– f3 � <br />.�2�:A 'C- <br />� �-/�L(�:�• �j� �Z . � <br />N, 5, E, W <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 />(7) MONTHLY SEWER CHARGES: <br />A <br />SEWER CONSTRUCTION <br />S <br />S <br />S �O-E�(:) <br />E 30-� rJ <br />TRUCK E <br />LATERAL <br />SEWER SERVICE �C���� <br />LOCATION OF SIDE SEWER OR TEE IN THE MAIN: �M'`• `� � bP �u�7�.o.2.c/� <br />!�G !�J n+1.)1 iu /�?+Ol�-cs� �iDPT �� c�J� /�_/d• j`'�•5 <br />CHART L �'� Zy-5� <br />INFO COMPILED BY: <br />APPROVAL: <br />47�79 <br />DATE <br />DATE <br />� <br />.1 <br />�. <br />