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. � � d <br /> �- , , <br /> . , <br /> �; ; � ,, BUILDING PERMIT INFORMATION <br /> ; <br /> , <br /> � ADDRESS � 3D cP-' �NAI FNl �j- � � <br /> I (1) BUILDING PERMIT FEE $ {�-+' �� S L�L <br /> + (lU PLANCHECKFEE Na4 � 3,3 '�V,3, ��7 � 0�.5�36 '��'3� <br /> � (nS,n('L <br /> ;i (2) PLUMBING <br /> j (3) MECHANICAL IJ.�1=-?�— <br /> � (4) STATE SURCHARGES <br /> � . (FQ BUILDING CODE �• �,'� <br /> (B) ENERGY CODE <br /> (5) DHIVEWAY PERMIT �-0� �� <br /> $ 8"8.���_ <br /> (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ G�� <br /> (A) TO BE DETERMINED BY BLDG. INSPECTOR � �— INCH <br /> i (� EXIST. WATER SERVICE APPLICATION NO. <br /> (7) STATUS OF SEWER CHARGES: <br /> � BOND_�DISTFiCT FOOTAGE N, s, �, w <br /> i \, , � ORDINANCE 1171-85 � <br /> . WATER ���� <br /> i \\ • � , , , SEWER �'�-1cP'9�� <br /> TOTAL ORD. FEE �Le,� <br /> � SEWER COItr;ECTION CHARGES <br /> � YEAR TRUNK $ ���� <br /> � <br /> � LATERAL — <br /> •! TOTAL CONNECTION CHARGES $ ��r� <br /> i <br /> , <br /> � . � p� <br /> � SEWER PERMIT FEE $ <br /> i <br /> i <br /> i <br /> 1 <br /> ' . <br /> .f <br /> �� <br /> .. .. . .. � . . .. . - �. . . ! . : . . . . . . ' . � . ., . . :(� <br />