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��`�. <br /> �.�. <br /> DE►ARTMENT OF COMMUNITY DEVELO�MENT SERVICES <br /> BUILDING PERMIT INFORMATION <br /> ADDRESS �`� n""` 'P�NE ST TYPE C�^� "� , <br /> (1) BUILDING PERMIT FEE �Co� 200� ODO• �' E CoSA7• �O <br /> (A) PLAN CHECK FEE P� � SO'�3 <br /> (2) PLUMBING �� ����~ <br /> (3) MECHANICAL �''� ��� <br /> ' (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��'��T ���o <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. . <br /> (C) APPROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SUANCE � - 25 FEET �-G"`�� DRIVEWAY(TYPE) S 2s . DO <br /> . E <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND DISTRICT FOOTAGE <br /> N, 5, E, W <br /> NOTES <br /> ���Ue�. �� "f� <br /> OQo 1�s-eo <br /> �Zt7� 'S <br /> Mo7�3� rt d.�-tm us�-s <br /> �37,d�T. 70 <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK 3 <br /> LATERAL <br /> TOTAL CONNECTiON CHARGES E <br /> SEWER PERMIT FEE s <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES � <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK s <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART <br /> INFO COMPILED BY: DATE — <br /> APPROVAL: DATE <br /> � -- <br />