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_-- __ _ _ _,-.,. . . <br /> � ENGINEERING DEPARTMENT <br /> q IIUILDING PERMIT INFORMATION <br /> - 2. ( � � <br /> ADDR�SS 'Q,�--� �^ n n t'��� j ? <br /> , • ;�, �r; TYPE <br /> 1) BUILD7NG PERMIT FEE $ <br /> (A) PLAN CHECK FEE $ _ <br /> 2) WATER SERVICE TO BE PAID BEFORE BUILDING n�� •���� :.^ . °�`' <br /> PERMIT IS ISSUED �o� W $ '��T •"" <br /> �p�" <br /> ��•'' <br /> (A) TO BE llETERMINED BY PLBG. INSP. ��� INCH <br /> (B) EXIST. WATER SERVICE� APPL. N0. —'- <br /> IC) APPROX. LOCATION $ �� n,•wrn - 1_1 � � � T"' � Q� �•a� �r�rr.�f ,. <br /> ' /'- � � I sC c �F CHART $ 'aZEa <br /> 3) DRIVE�4AY PERM T TO BE PAID BEFORE BUILDING c � <br /> PERMIT IS ISSUED 2'� FT. Ct� n c_ D/W (TYPE) /'� ' $ ??. , a f3 <br /> G(/�/G �,6 <br /> TOTAL*�� $ <br /> 4) STATUS OF SEWER CHARGES: <br /> BOND�_ DISTRICT 2 t% FOOTAGE <br /> N, S, E, W. <br /> NOTES SEWER CONNECTION CHARGES: <br /> YEAR �7G. TRUNK $ / r/5; °C <br /> C�� CL � ��._ <br /> ' �j- 3o - 12Z --Ov �c-Q . lIZ - <br /> TOTAL CONNE T 0 HARGE $ <br /> �O. � <br /> SE��ER PERMIT FEE $ 'f't-�- <br /> CATCH BASIN PERAIIT I'EE $ '"""` <br /> I TOTAL SEWER PERBIIT FEES $ �; Q• �� <br /> 5) ASONTHLY S�WER CHARGES: <br /> SEWER CONSTRUCTION: <br /> TRUNK $ /•�S <br /> I,ATERAL $ - <br /> SEWER SERVICE: $ � 's$' <br /> APPROX�. LOCATION OF SIDE SEWER OR T�E IN THE MAIN: �.7.5 a f( ' J�� o/ /tH <br /> �� 1 i *' 1�1e i� {'��':e w �/O r !� C � r1�� t+a� ) t 2 � ��e D � ?R �'/r <br /> • • • CHART ' l� �- :�l?-r- <br /> INFO COMPILED BY: ,J�''��� DATE � �:�f'� f`�'� _ <br /> R�V I E�4: DATE <br /> PROJECTS DIVISION <br /> APPROVAL: DATE <br /> ENGINEERING DEPARTMENT <br /> * This total must be paid before building nermit is issued. <br />