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<br />: ��: : BUILDING PERMIT INFORMATIOiV
<br />�'i1DDRE5S R�''R' � �u�'�LT� DLv� TYPE���
<br />,,_(1) BUILDING PERMIT FEE , �oS��• � S
<br />(A) PLAN CHECK FEE
<br />_, (2)� PLUMBING a�
<br />.. �(3)�1'v1�CHANICAL�' .
<br />'. .(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PER� ISSUANCE
<br />'"' (A) TO BE OETERMINED BY BLUG INSPECTOR �� INCH
<br />'(B) EXIST. WATER SERVICE, APPLICATION NO.
<br />_'�'�`.�' (C) 'APPROX. LOCATION
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<br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- ,
<br />•.;��.SU/1NCE FEET DRIVEWAY(TYPE) S _
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<br />;(7) STATUS OF S WER CHARGES: � ��`,`.
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<br />BOND DISTRICT FOOTACE - — � a
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<br />..___... . NOTES
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<br />�,��:a,- � SEWER CONNECTION CHARGES
<br />�'�C1�` -� � YE11R 8� TRUNK
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<br />� LATERAL
<br />' TOTAL CONNECTION CHARGES
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<br />• SEWER PERMIT FEE
<br />� � CATCH BASIN PERMIT FEE
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<br />TOTAL SEWER PERMIT FEES
<br />��(7) MONTHLY SEWER CHARCES:
<br />� SEWER CONSTRUC710N
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<br />TRUCK s
<br />LATERAL
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<br />''�, ' ' SEWER SERVICE
<br />i1PPROX. LOCATION OF SIDE SEWER OR TEE IN THE M�IN:
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<br />: .•,INFO COMPILED BY:
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