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� <br />BUILDING PERMIT INFORMATION <br />ADDRESS � �- TYPE �i�i%��� • <br />(1) BUILDING PERMIT FEE SD�DO� ^� � � b ¢�Q'� U <br />(A) PLAN CHECK FEE QiiC���� 9G C—F'O M SOZ(o� <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) WATER $ERVICE TO BE PAID !'KIUR TO BUILDING PERMIT ISSUANCE �%,YD•O] <br />(A) TO BE DETERMINED tiY BLDG INSPECTOR � INCH <br />(B) EXIST. WATEP. SERVICE, APPLICATION O. <br />(C) APPROX. LOCATION ���.V�� ���� 37r"7 � <br />f� � OC /��t/U.4LG('HART y' 7iO' Z9' S <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE fEET DRIVEWAY(TYPE) S �5' � U <br />S <br />(7) STATUS Of SEWCR CHARCES: <br />:• � <br />NOTES <br />DISTRICT <br />!>f�F�.�G �G<r� �'rr�� <br />p,s.o i/1/- 8`✓-- <br />y2 0 ; .�8.o z <br />,�EZU �72 ; / OO • G 'Z <br />�JS <br />FOOTAGE /U(�Pi�/�iJ� <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGF.S <br />SEWER PERh11T FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />TRUCK <br />LATERAL <br />f _ <br />E _ <br />s �G.OU <br />y �s')./� � -- — <br />5 <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: �z� /�II.� �/.J ,�1�'!r'D�! �i 0l' <br />INFO COMPILED 8Y: <br />APPROVAL: <br />5 84 <br />CHART U-'ZO- Zq'S <br />DATE <br />DATE <br />