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ENGINEEItING DEPARTi•]ENT <br />` � HUILDING PfiRMIT ZNFOR6IATION <br />11DDRLSS _�i �/ ��. "� j�r �.,, ef 6„ t; <br />1) IIUILDING PL•'R•ffT I'LE Z� �p�' �� <br />(el) PL11N CFI�CK EE� <br />2) NATER SERVICE TO IIE PAID BEFORE DUILDING <br />P�RA1tT IS ISSUED <br />Tl PE �' �'' <br />S � �. OO <br />S _�c Z , c.� c�_ <br />S 2c: -��, <br />(�l) TO BE DETER[dIi<ED BY PLIIG. INSP. � INCH I"����r �� <br />(B) �}�IST. �9eiTER SERVICE, APPL. N0. <br />� <br />IC) APPROX. LOCATION 10 ! Fi ,� I' ``. G'� %i <: �+•:: .�✓,' <br />CHART _'i --!_"7 <br />3) DP.IVGPiAY PSRI•IIT ^10 BE PAID IIEFORI: IIUILDING <br />PER'�1ZT I.c, ISSUED ��I FT. %'�.('�(-F D/W (TYPE) <br />TOTAL* <br />4) STATUS Of' SE['J�R CHARGES: <br />BOND�_ DISTRICT ?']_ FOOTAGE -----__._ _ <br />N, S, E, iV. <br />�j-ZZ—�.���5-OU <br />I S,Q,,�,er �0 6C2� C�ak�e;; <br />i 1 <br />I �posseS �.�. Cdrnir oi <br />, Le'h r9 , �C�� PQSc�+R��� <br />4r' �r ia C4'r'IOI1, <br />i � <br />I <br />i <br />�) >:J:JTI;LI' SLP,'�R r'HAPGL'S: <br />SEi:liR CO::STRCCTIO.:: <br />S�6;TR S��`:ICB: <br />SE�rER CONNGCTION CHARGES: <br />YEAR ' 7 G TRU\K <br />����� <br />!�:(. i� <br />TOT.1L CONNE ,I � fIARGE <br />SE�•7ER PEI2bIIT I'EE <br />Ct1TCH IIASIN PLR�:IT Fi� <br />TOTAL SL'IiER PERr1IT Pi.ES <br />S �'S S ,u <br />S. t �.�e '�'�_ <br />S_ 3►i,so <br />S S 0 7. ,-� __ <br />$ 30, o0 <br />$ '—' <br />$ �--�. 00 _ <br />TP.UNY, $ J,�!r' <br />i.:iTExAL $ E•ZS <br />S 2. SP <br />�rn.�,p�{, LCC�TIO"7 OP SIilF. SES•7GR OR T�� IN THE 61AIN: <br />'"� �.s'� rS_fs �'r — S, n' A/. e� h?. .N. o�' C? c(r <br />-----'�—� ` t — CH <br />IidPO CO^iPILP•.D EY: �. ,.�'.• _ _ _ <br />I?ri'IES4: <br />PhOJBCTS DIVISIOV <br />APPROVAL: <br />�(.i,I'.di:':RING llGPART61L:iT' <br />, <br />� <br />-�-- <br />Di�TE <br />Dt>TE <br />De�.Ti: <br />* This total rnust Ue p�id before buildiny nernit is issucd. <br />