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;�� <br /> :��� �, <br /> DEMRTMEHT OF COMMUNITY DEVELO�MENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> ADDRE55 3�! �o������� �`Up. TYPE 5•�'� <br /> (1) BUILDING PERMIT FEE 4-S,LrY]' �U S 27¢"BO <br /> (A) PLAN CHECK FEE fp .�'' lo�Lo9z <br /> 2B•B ll <br /> (2) PLUMBING ZB-5a <br /> (3) MECHANICAL • Qp <br /> (4) WATER SERVICE TO BE PAID PRIO.^. TO BUILDING PERMIT ISSUANCE ` <br /> (A) TO 8E DETERMINED BY BLDC INSPECTOR�INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION � ` �n•� �'"�'��` ��' �- • <br /> --No w�D�� s fu/�Y� `za �lc�� � <br /> ' E BG 5� 0/t �/.lJ CHART �` ZZ 7 <br /> � (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- a <br /> ' SUANCE FEET DRIVEWAY(TYPE) f �' B <br /> S <br /> j (7) STATUS OF SEWER CHARGES: <br /> 80ND .�—DISTRICT FOOTAGE <br /> N, S, E, W <br /> a . <br /> ; NOTES <br /> � .��' E�E� Dc�/bZ,E.7�i�+��UT �5 <br /> :; <br /> ;; 02t� 7ZZ� 8D <br /> � -- --- <br /> ?_ �(%'L1__'Z __ — — . _ . — — __ <br /> i <br /> � �3 F� �Zf� �339,D� • <br /> r <br /> ;,1 _ <br /> '.i <br /> ��' SEWER CONNECTION CHARGES <br /> ' YEAR � TRUNK� S 270` � O — <br /> ';� <br /> ; LATERAL <br /> � TOTAL CONNECTION CHARGES S Z7O� �� <br /> , <br /> :� , <br /> r SEWER PERMIT FEE S �D. DT� <br /> ", CATCH BASIN PERMIT FEE �� <br /> =� TOTAL SEWER PERMIT FEES s _ '�'� <br /> '<<; ' <br /> (7) MONTHLY SEWER CHARGES: <br /> } SEWER CONSTRUCTION TRUCK s <br /> �: LATERAL <br /> �i <br /> � SEWER SERVICE <br /> �;;. APPROX. LOCATION OF SIDE SEW�R OR TEE IN THE MAIN: � di� P/i 1��i0��-- <br /> , - <br /> '-; /ra`�F'7 !�'� D� �4i �%—�P�' Q E3 ZYr S <br /> '�;.� CHART <br /> `� INFO COMPILED BY: DATE <br /> �' APPROVAL: UATE _ <br /> ; <br /> ;�� <br /> ';:; <br /> . ..:� <br /> 41•79 <br /> '�i <br />