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� <br /> BUILDING PERIIAIT INFORMATION <br /> ADDRESS 7�r �0 .�/l� .z-/�r ,-'/�^ -- <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 ���'�J' �3 <br /> $ -�Tf'f�-�' <br /> (6) WATER SERVICE TO BE PAID PRIOR TO BUILDIiVG PERMIT ISSUANCE $ ���.D• �ZZc .� " <br /> (A) TO BE DETERMINEQ BY 'iLDG. INSPECTOR__. INCH � 2 y <br /> (B) EXIST. WATFR SERVICE APPLICATION NO._ -- <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND_ DISTRICT FOOTAGE <br /> N, S, E. W <br /> ORDINA�ICE 1171-85 <br /> WATER -. ���r�Z <br /> SEWER - l�� � <br /> TOTAL ORD. FEE = 9 7� _ <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK $ _ <br /> LATERAL -� <br /> TOTAL CONNECTION CHARGES $ . - <br /> SEWEf PERMIT FEE � �(� <br /> C <br /> ��U <br /> . <br /> (�� <br /> ��, <br /> �r <br /> G�l G�G�a r,X <br /> ' �� \ ��l <br /> G,� �' <br />