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• DEPAitTMENT OF CJMMUNITY DEVELOPMENT SERVICES <br /> BUILDING E��:RMIT INFORMATION <br /> ADDRE55 / � � � �" "J I �"'L"`� ' �G'c TYPE �����h � <br /> (1) BUILDING PERMIT FEE yI� p 00 � b �7�- <br /> (A) PLAN CHECK FEE ��z <br /> (2) PLUMBING �� ��;� <br /> (3) MECHANICAL <br /> 1z--�� <br /> (4) WATER SERVICE TO 8E PAID PRIOR TO BUILDING PERMIT ISSUANCE L>O <br /> (A) TO �E DETERMINED BY BLDG INSPECTOR�—INCH <br /> (B) EXIST. WATF.R SERVICE, AP�LICATION NO. <br /> (C) APPROX. LOCATION _ . <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS• o� <br /> SUANCE FEET DRIVEWAY(TYPE) 5 �-'�� <br /> S <br /> p) STATUS OF SEW R CHARGES: <br /> f30ND �DISTRICT FOOT�GE _ <br /> N, S, E, W <br /> NOTES <br /> SEWER CONNECTION CHARGES � <br /> YEAR �� _TRUNK b �i30 <br /> LATERAL � -' <br /> TOTAL CONNECTION CHARGES s 330 � <br /> � <br /> SEWER PERMIT FEE s 3� <br /> CATCH DASIN PERMIT FEE � � <br /> TOTAL SEWER PERMIT FEES S �� <br /> (7) MONTHLY SEW[R CHARGES: <br /> SEWER CONSTRUCTION TRUCK b <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> CHART S /3 �2 � y <br /> INFO COMPILED [3Y: DATE <br /> � APPROVAL _ DATE <br /> 9779 <br /> _ _ . . . . . _ . . . _. .. . . <br />