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.� <br /> ENGINEERING DEPARTMENT <br /> BUILDING PERMIT ZNFORMATION <br /> : �- � - i�i;::� " - S� E . TYPE � . <br /> ADDRESS - ,r �.' ; _ -- r' i .': , <br /> 1) BUILDING PERMIT FEE $ r�� <br /> (A) PLAN CHECK FEE $ N� '— <br /> 2) WATER SERVICE TO BE PAID BEFOPF. BUILDING $ ,r/!,`i, t��,; <br /> PERMI; IS ISSUED <br /> (A) TO BE DETERASINED BY FLBG. INo'P. ���. _ INCH <br /> �- oFF - <br /> (B) EXIST. �� WA2ER SERVICE, APPL. N0. l��-iJG='� oUre SY�S� <br /> (C) APPROX. LOCATION �'- , �."J. �`��' �%/`Si..°.=!;/ G�'ar` �;'; <br /> "f � ' %�%ZVv /¢ � E �' 2A�'�Ur-= CHART W-31'�� <br /> �'"Vti(Z , i <br /> 3) DRIVEWAY PERMIT TO BE PAID BEFORE BUILDING ,j� .--� <br /> PBRMIT ZS ISSUED /� FT. /?Sf-'/�fit,�-D/W (TYPE)y $ ; • • ��_ <br /> �?/� `�/OTAL*� � � �_.� <br /> 9) S7:'�TUS OF SE47ER CHARGES: � ' <br /> BOND �T DISTRICT •-� FOOTAGE --�- - - - <br /> N, S, E, W. <br /> Acc,o�,u�; 3 =i� l'i'"' o0 <br /> NOTE:� SEWER CONNECTION �_HARGES : <br /> �(�, ��/ „ YEAR �� TRUNK � . S 1 ..' <br /> �` ���l.G !�J LG(i�•�i-r�i'Ir:��LC�/1 K %� ' . <br /> .�Ct�+'�" ( $ ' �• <br /> '�Z�S. 00 �,��u�-`G� /�TE � 2¢�?� , � ��- <br /> � ��� v�� T�TAL CONNECTION�AKGE �� $ ^�'S'.On <br /> �_ �~��G��yPiw✓ N'r"""'` � SEWER PERMIT FEE $ .�G-�.C�� <br /> '?��o -a,,"ti� .�s-�-.�?-, <br /> bui Id 1� ^ .� ' ���+`1 � ' CATCH BASIN PERMIT FEE $ <br /> "�w = -� '`� t r ! <br /> G�. � ' • TOTAL SEWER PERMIT FEES $ �.� Q •�Q <br /> 5) MONTfILY SE�4ER CHARG�S: <br /> SEWER CONSTRUCTION: <br /> TRUNK $ � �i� <br /> LATERAL $ ���.S <br /> �%' C <br /> SES9ER SERVICE: $ `� � �� <br /> 1;..: ; ��'G��:� � <br /> APPRO%. LOCATION OF SIDE SEWER OR TEE IN THE MAZN: � F,f'•'��`✓ '� � � <br /> �� <br /> �D 1-'- ' -..�.-� p-i• ' .rY-a/yi --�- <br /> � '�'� C,,�' d7''_� , =. - <br /> . ' � �� �; >%�„ C ART i� z.r , <br /> - � --z.-s '1��-�,. ��L _•^'�--��- .`, � <br /> INPO COMPILED BY: 7�,.-�^-'7/7C�..C�G`<'.%�''• FjI,G�frx DATE 3-/7-'��� <br /> �� ,� • <br /> ?2liVIEW: '� DATE <br /> .,/ P OJE TS DIVISION <br /> ���L./t ��/9P_� U�{�A.�f�. �-I DATE �. <br /> APPROVAL� � <br /> ENGINEERING DEPARTMENT <br /> � �vo � ; oF sEwr_r>_ �� P/Z���-�2�IY PE�z k�FcoP_t� s - , <br /> * Tn°��otai must b��P id`��'�'o�`e"b�iai-� ����i'� �§°�G�d:'' �v 5.' < � �c�:�a� <br /> 1 <br />