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� <br />BUILDING PERMIT INFORh1AT10N <br />ADhRE55 �� w' MPfitl�s'�(N l,VI� TYPE 5��+� �'��� �'� <br />. <br />(1) BUILDING PERMIf FEE SI�� s 8� a� <br />(A) PLAN CHECK FEE 4�•82 17u� <br />(2) PLUMBING 20-d0 <br />(3) MECHANICAL o����m� <br />(4) WATER SERVICE TO OE PAID PRIOR TO BUILDING PERMI�ISSUANCE '�, �� g D�Y <br />(A) TO BE I�ETEtiMtNED BY BLDG INSPECTOR ��. �NCH <br />(B) EXIST. _ WATER SrRVICE, APPLIC�ITION �IO. <br />(C) /1PPROX. LOCATION S�MA �� d�P� �� r'T S <br />OP � Ci UU.�'�ItXu ��HART T� �3� 28�� <br />(5) DRIVEW1IY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- ZO,OO <br />SUANCE FEET DRIVEWAY(TYPE) S <br />S <br />(7) STATUS OF SEWER CHARGES: <br />BOND � DISTRICT FOOTAGE <br />N, S, E, W <br />NOTES <br />�Jf.ap�.�/�,�, S!r'+dl13R- �� <br />p PA [ �'7/�$% <br />F. �, __-� <br />li9.no <br />d.1l�v o <br /># ��,eo <br />SEWER CONNECTION CHARGES <br />YEAR 8� TRUNK <br />LATER1IL <br />TOT/1L CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEE.� <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK <br />L/1TERAL <br />SEWER SERVICC <br />APPROX. LOCATION OF SIDE SEW <br />INFO COMPILED BY: <br />APPROVAL: <br />5•84 <br />s �jp. B O <br />39s•d� <br />s 7Z5, vo <br />S 3O,Ob <br />s �,s d <br />E7 <br />OR TEE IN THE MAIN: 8�� /�/�a�� �oor�+c <br />CHART �' <br />DATE <br />DATE <br />