Laserfiche WebLink
. <br />I <br />A;hDRESS� <br />TYPE OF BUII <br />BUILDING PERMIT TNFORMATION <br />c� /'�C`� L' ��� k= l�/�' C( r��' <br />1) BUILDING PERMIT FEE ��_p, i8 `,, �r� <br />(A) PLAN CHECK FEE <br />2) WATER SERVICE TO BE PAID BEF'ORE BUILDING <br />PERMIT IS ISSUED <br />(A) TO BE DETERMINED BY PLBG. INSP. INCH <br />(B) EXIST. �/- WATER SERVICE, APPL. NO. i-%J�_� ��� <br />(C) LOCATION .'/�'�C� ���T �� <br />CHART i /_I <br />3) DRIVE�VAY PERMIT TO BE PAID BEFOFE BUILDING <br />PERMIT,I�S ISSL7ED FT. D/W (TYPE) <br />� ;; �;- 7 t %C � �' � i`iC" C . - �,� �� <br />� TOTAL� <br />4) STATUS OF SEWER CHARGES: , <br />BOND 11__ DISTRICT �� �;?• E'OOTAGE � � �-� <br />N, S. E.i W: <br />LANDSCAPE NOTES SEWER CONNE;CTION CHARGES: <br />TRUNK <br />> ''-. -- ^; � _ ^ <br />_ ,, <br />_> � ' <br />_ ,� � v <br />1�"- <br />,�i"(�L',.t�� SID�/Ii' 1;'/-,'"'�.�`:�`•�' <br />��� <br />LATERAL <br />TOTAL CONNECTION CHARGE <br />iSEWER PERMIT FEE <br />CATGH BASIN PF.RMIT FEE `� <br />TOTAL SE1'VER PERMIT FEES <br />5) MONTHLY SEWER C�-IARGES: <br />SEW.ER CONSTRUCTION: <br />TRUNK <br />LA'TERAL <br />SEWER SERVICE: <br />LOCAT�ON OF SIDE SEWER OR TEE IN THE MAIN: CHART <br />] > > '� <br />,_ , : �,. , ; �r <br />.�'� l:'�'i c;.`', ,,, "�, �,<<� ,' _ ,_ <br />) <br />� ;' 1' �';r', ��� � � / fi ''��% '� � '- ' ,;C� ��.. <br />,; . <br />INFO COMPI ED BY: � =. /' , .. ' <br />REVIEW: <br />APPROVA <br />mThis total must be paid before building permit is issued. <br />_ _ _- - <br />$ <br />$ ��. � <br />,,, <br />Y� r;! .�'rr��r ;n.. <br />��;,��J . <br />DATE /:�'� <br />DATE �-�6' 7� <br />DA T ���=��_ <br />