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i <br /> � C� � <br /> BUlLDING PERMIT INFQRMATIOI�! <br /> N 7 l �y} � <br /> ADDRESS � ICs'C ' � ��IC�,1_1L2��C_�I- --- --- ------ <br /> 7 � � <br /> (1) BUILDING PERMIT FEE � ' �l �% ', <br /> (A) PLAN CHECK FEE <br /> �� (2) PLUMBING -- <br /> ��"q (3) MECHANICAL <br /> C�H (4) STATE SURCHARGES ��G� <br /> a''3�' (A) BUILDINGCODE I�� <br /> � �� (B) ENERGY CODE <br /> � N� (5) DRIVEWAY PERMIT - �,_.7a���2. <br /> 5 .. <br /> VJ H - <br /> H <br /> x <br /> x y� ^� <br /> [sJ <br /> (8) WATER SERVICE TO BE PAIU PRIOR TO BUIIDING PERMIT ISSUANCE 5 — ���-- <br /> ��g (A) TO BE DETERMINED BY BLDG. INSPECTOR—��_- INCH <br /> x y� (B) EXIST. —WATER S�RVICE APPLICATION NO. -- <br /> � H y (7) STATUS OFj'S'EW� ER CHARGES: �l I <br /> g �� B O N D�—_ DISTRICT _ FOOTAGE N—�C E�W ` <br /> � �� <br /> y p y ORDINANCE 1171•85 �, S�� <br /> WATER � <br /> l i'-� <br /> SE�NER 1 � J /x ��' <br /> ' ',,r'l� �'-L� <br /> TOTAL ORD. FEE ��— <br /> I�� SEWER CONNECTION CHARGES � �p ��, <br /> YEAR TRUNK 9 _ `�O�` <br /> �� ... LATERAL <br /> �" i TOTAL CONNECTION CHARGES S '���=— <br /> 1` � ��� <br /> �`� SEWER PERMIT FEE 5 ��' <br /> �� � <br /> � �� <br /> � � <br /> ���� <br />