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BUILDING PERMIT INFORMATION <br />ADDRESS _ <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PERMIT <br />S <br />(6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ <br />(A) TO BE DETERMINED BY BLDG. INSPECTOR __- INCH <br />(B) EXIST. - WATER SERVICE. APPLICATION NO. <br />(7) STATUS OF SEWER CHARGES: <br />BOND _ -DISTRICT _. __ _ FOOTAGE - <br />N, E, W <br />ORDINANCE 1171.85 <br />WATER <br />SEWER <br />TOTAL ORD. FEE <br />SEWER CONNECTION CHARGES <br />YFAR _TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />S -- <br />SEWER PERMIT FEE $ - _ _---- <br />