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DF�ARTMENT OF COMMUNITY DEVEIOPMENT SERVICES <br />BUILDING PERMIT INFORMATION <br />ADDRESS � �� � � G��`-� � ��� TYPE l� • `/'�• <br />(1) BUILDING PERMIT FEE'S�l/-�c�Y.�. �U $ �`�' �� <br />(A) PLAN CHECK FEE Pr�,# `�C�-�J3 <br />(2) PLUMBING —3�'�� <br />(3) MECHANIC,qL � �„ U�� <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE �'�`� •� <br />(A) TO BE DETERMINED BY BLDG INSPECTOR � INCH <br />(B) EXIST. WA�i:R SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION � �• G -�- /-r�.�� � ,� ' �. '`-'/_ <br />(�o' ��u� � l r + —� � <br />�C�7��v' �C�c �✓rC) CHART <br />f5) DRIVEW.4Y PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE � r FEET �����- �� DRIVEWAY (TYPE) S <br />$ C� 7'Z : _� <br />�O <br />(7) STATUS OF SEWER CHARGES: <br />BOND � DISTRICT <br />NOTES <br />l�ti.,i�.-,� 7� e �C,�'�✓!c-X�1 T �s <br />O�'IJ 7l 'Z -- 8 U <br />�� � <br />G /�G��, �c"? C> <br />FOOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR _ �>%'� TRUNK <br />LATERnL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />g 27ct _�c-- <br />��-v�. <br />$ 7�Gc;o_ <br />3 --' �%• 0c' � <br />g �(�� C.`-�Y� <br />(7) MONTHLY SEV�GR CHARGES: <br />SEWEfi CONSTRUCTION TRUCK $ �` � �J <br />LATERAL 2' �' �'— <br />SEWER SERVICE �� �`� — <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: ����� �% �'�"f'�''�`"'� — <br />i.-� ,.-,_ ii � ...- c� �„�� CC_'��t.>>.�; /.�.t��G �����' . _ ,-li:� �.��>cs'F.)t. . <br />INFOCOMPILED BY: <br />APPROVAL: <br />9�1�79 <br />CHART � ''�4 - G�f - <br />DAT� <br />DATE <br />� <br />� <br />