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E �� ��.,, <br /> � s----x <br /> ' ;; <br /> BUlLDING PERMIT INFORMATION <br /> �� � � �J � �CY��d� . <br /> ADDRESS �lC I I ��f� � '�S �IC��� — <br /> (1) BUILDING PERMIT FEE / �— S ��� <br /> (A) PLAN CHECK FEE <br /> (2) PLUMBING <br /> �i.�,y"� (3) MECHANICAL <br /> q�� (4) STATE SURCHARGES — � � ;� <br /> �..>, y N (A) BUILDING COUE <br /> y ��.�i (B) ENERGlCOUE <br /> � y� (5) DRIVEWAYPERMIT <br /> �°aH� � — `�7�- <br /> V]H <br /> OZ O�i <br /> �� (o) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE 9 � ��,�^ <br /> ��g (A) TO BE DETERMINED BY BLDG. INSPECTOR �� �1 INCH <br /> Za y� (B) EXIST. WATER SERVICE APPLICATION NO. <br /> t" i.,�y (7) STATUS OF SEWER CHARGES: <br /> p �N BOND_���_ DISTRICT FOOTAGE�^��� <br /> N, S, E N1 <br /> h7 �C+7 <br /> y py ORDINANCE 1171•85 / '��� �'C% <br /> W�1TER Ic�I �� �=�— <br /> SEWER � <br /> TOTALORD FEE I���� '� <br /> �`� SEWER CONNECTION CHARGES Q Sc� <br /> YEAR_ TRUNK S � 'J� <br /> �� <br /> �.� ..�' LATERAL <br /> " '� 1 TOTAL CONNECTION CHARGES S ^��� � <br /> 'r � � <br /> i <br /> +� SEWER PERMIT FEE S s�{��1 <br /> ��'�� I <br /> 1 <br /> � � <br /> �_'�� I <br /> � •� I <br /> I <br /> I <br />