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��� <br />0 <br />�Hti <br />K�n <br />Hy� �I <br />'�M� <br />VJ H <br />H <br />xp <br />OHh�y <br />i-�itdC <br />�r n <br />t"y� <br />HH <br />gy <br />H <br />Cq] C7 f� <br />h7 � [�1 <br />XHCn <br />HO�n <br />BUILDING PERMIT INFORMATION <br />' � � �� i o��� - �;c <br />ADDRESS _ � J IS ��l_1, �-------- ---- <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE I 91. �p — 1(n B.U3 <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGI' �ODE <br />(S) DRIVc��VAY ?ERMIT <br />- -. <br />G„� �, �� �� �,�� y�� o� <br />---- -- — ------ -- - <br />� __�p�L:C1lJ _ <br />--- - —'�—F�S1— <br />- �'�QG--- <br />_ -��-�-a-� _ <br />— `L1 Q <br />S -_ <br />(6) WATER :iERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE S <br />(A) TO BE DETERMINED BY BLDU. INSPECTOR__ _— INCH <br />(B) EXIST _ WATER SERVICE APPLICATION NO. ___— _ <br />(7) STATUS OF SEWER CHARGES: <br />2,�ND_ DISTRICT FOOTAGE--_ <br />-- N, 5, E. W <br />ORDINANCE 1171-85 <br />WFTL-R <br />SEWER <br />iOTAL ORD. FEE <br />SEWER CONNECTION CHARGES <br />YEAR_____ __-_-_ TRUNI( <br />LATERAL <br />TUTAL CONNECTION CHARGES <br />S[WER P[RMIT FEE <br />S_ <br />S <br />� <br />