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<br />PERMIT INFORMATION
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<br />(1)�BUILDING PERMIT FEE 6C`�� �' , s — , � ,.,''
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<br />''' �� �(I1) PLAN CHECK FEE ,
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<br />-- (2) PLUMBING '
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<br />•�'. (4) WATEfi SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��}-�9- � �
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<br />;.:•;; "(A) TO BE DETERMINED BY BLDC INSPECTOR�—INCH ���j u �pp�
<br />°""�r`��= B EXIST. WATER SERVICE, APPLICATION N0. ���
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<br />�'' ''''� '" (C) APPRUX. LOCATION
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<br />+��"�"'' S) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS-
<br />Cz` "' FEET DRIVEWAY(TYPE) S 2Q•�U
<br />.� t:;� SUANCE . , '
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<br />.,F. 1tn(7) ST�TUS OF SEWER CH�RGES: --. a:�-
<br />�� �' ` BOND �---DISTRICT FOOTAGE
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<br />�'���`' � � NOTES
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<br />SEWER CONNECTION CHARGES
<br />YE/►R � � TRUNK
<br />L1ITERAL
<br />TOTAL CONNECTION CHARGES
<br />� - � � SEWER PERMIT FEE
<br />CATCH BASIN PERMIT FEE
<br />i l' �'�� TOTAL SEWER PERMIT FEES
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<br />;7) �MONTHLY SEWER CHARGES:
<br />SEWER CONSTRUCTION
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<br />TRUCK s
<br />LATERAL
<br />SEWER SERVICE
<br />PFROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN:
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<br />INFO COMPILED BY:
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<br />APPROVAL:
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