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� <br /> . , � <br /> ,s::;�� <br /> DEPARTMENT OF CUMMIINITY DEVELOPMENT SERVICES <br /> BUILDING PERMIT Ih1FORM/1TION <br /> ADDRE55 � �. �'����LY�1 /� v� . TYPf: 5•/C/� <br /> (1) BUILDING PERMIT F':E ¢8��_� S 27¢' �a <br /> (A) PLAN CHECK FEI: S 2' !D S <br /> (2) PLUMBINC _ 2O '� <br /> (3) MECHANICAL �2'� <br /> (4) WATER SERVICE TO BE PAID PRIOR TO DUILDING PER IT ISSUANCE ¢�' <br /> (A) TO BE DETERMINED BY BLDC INSPECTOR �� INCH <br /> (B) EXIST. ,_ W�TEP, SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATIONU������ �P¢� 7FT <br /> �J B��. Df IZ�Gf� CHA.r.T Z� /3-Z$ � Y- Z <br /> 0 <br /> -� <br /> (5) DF'VEWAY PEF.MIT TO k;E PAID PRIOR TO BUILDING PERMIT IS- ; <br /> SUANCE F[ET DRIVEWAY (TYPE) S 2�' � _ m <br /> �, <br /> -_ .. .. <br /> ___"_' ___ . -I T <br /> (7) STATUS OF SEWER CHARGES: '" —' <br /> N m <br /> BOND _� DISIRICI� _F007AGE <br /> 0 <br /> co <br /> m o <br /> N, S, E. W -i c <br /> 03 <br /> NOTES = � <br /> m <br /> st�v�-� DEv F� �n � <br /> �¢� ?8¢-�3 � _ <br /> =�� <br /> ' s�e �s�•�' ` -� <br /> on <br /> i -i m <br /> x <br /> m � <br /> N <br /> O <br /> o r <br /> c-�m <br /> c �n <br /> SEWER CINNECTION CHARGES Z � <br /> � YEAR _ 8 � TRUNK S 33��� � � m <br /> 3 4s'-� ' <br /> LATERAL A <br /> 7ZSnc� � <br /> TOTAL CONNECTION CHARGES 3 Z <br /> -� <br /> SEWER PERMIT FEE $ ��' �� � <br /> Z <br /> CATCH BASIN PERMIT FEE -^ � <br /> TOTAL SEWER PERMIT FEES $ __30 ' B� m <br /> (7) MONTHLY �EWER CHARGES: <br /> SEWER CONSTRUCTIGN TRUCK 3 <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOC,4TION OF SIDE SEWER OR TEE IN THC MAIN: S�� �A�� ����' 2 •S` - <br /> �� ,t,� � � Gnr A�r�/�ao,� �8 �r �� g+r M.� 3Z- 6. <br /> CH.ART � ' �3—�� <br /> INFO COMPILED BY: _ DATE � <br /> APPROVAL: _ _ DATE <br /> � <br /> s ea <br /> ,. <br /> i . <br /> � i <br />