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ENGINEERING DEPARTMENT <br />BUILDING PERMIT INFORMATION <br />ADDRESS 53 D 2 O C e a ll A v P TYPE <br />1) BUILDING PERMIT FEE $ <br />(A) PLAN CHECK FEE $—'2cy -��_ <br />2) WATER SERVICE TO BE PAID BEFORE BUILDING <br />PERMIT IS ISSUED �%$ 2 On. O<) <br />(A) TO BE DETERMINED BY PLBG. INSP. 3/¢ INCH `��`f '33 Ov <br />(B) EXIST. WATER SERVICE, APPL. NO. �^^ <br />(C) APPROX. LOCATION _jL .3 q' E o7' � 07 <br />ryein 4 CHART <br />3) DRIVEWAY PERMIT TO BE PAID BEFORE BUILDING <br />PERb;IT IS ISSUED Z S- FT. D/W (TYPE) $ 12,116 <br />i <br />,, pp,, TOTAL* $ <br />4) STATUS OF SEWER CHARGES:r��l <br />BOND_ DISTRICT FOOTAGE - <br />N, S, E, W. <br />3 - Zg - 00 <br />SEWER CONSTRUCTION: <br />SEWER CONNECTION CHARGES: C•I,D. <br />YEAR 176 TRUNK $ — <br />/ T L $ 1 4S. UO <br />• /y� <br />TOTAL CONN I CHARGE $ J9S• o0 <br />SEWER PERMIT FEE <br />$ 3 0 • 00 <br />CATCH <br />BASIN <br />PERMIT <br />FEE <br />$ <br />TOTAL <br />SEWER <br />PERMIT <br />FEES <br />$ <br />TRUNK $ / , 1_57 <br />LATERAL $ <br />SEWER SERVICE: $ 1•� <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />REVIEW: _ <br />PROJECTS DIVISION <br />APPROVAL: _ <br />ENGINEERING DEPARTMENT <br />DATE 7 - / Z - 76 <br />DATE <br />DATE <br />* This total must be paid before building permit is issued. <br />