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�s � 1 , I , .: j4 <br />�..,,' � : . . <br />,`'�.�.....� �' J . � . .a.. _. . <br />o-r� �=��. BUILDINGtPERMIT�:IN�ORMATION . <br />:�v,. . ..� <br />f'_ . . , ` ;,� <br />�,: `��. . . . •„� �� . <br />�: : ADDRE55 �� I I �Y �" � TYPt <br />(1) BUILDINC PEQMIT FEE S 3� <br />- - (A) PLAN CHECK I'EE ��� <br />_„_(2) PLUMBING �y � <br />.(3) HIECHANICAL <br />(4) WATER SERvICE TO 8E PAID PRIOR TO BUILDING PERMIT ISSUANCE _� ,��L� <br />(A) TO BE DETERMINED BY BLDG INSPECTOR 3I� �� INCH � <br />_ (E3) EXIST. WATER SERVICE, APPUCATION NO. <br />, (C; APPROX. LOCATION <br />CHART <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE FEET DRIVEWAY (TYPE) S <br />b <br />�' p) STATUS OF S-�EWER CHARGES: <br />80ND _�,,�—DISTRICT FOOTAGE <br />N, S, E, W <br />NOTES <br />i ►'1 I-85 <br />� -�q �a W�T� <br />�-{�`71 °� ���� <br />�� <br />'"� SEWER CONNECTIOn CHARGES <br />YEAR TRUNK <br />�. <br />4\�; , LATERAL <br />�F^'- TOTAL CONNECTION CHARGES <br />..�� - <br />'-�.�.i.._ : . . <br />� � �f.,:,._ <br />y��' � SEWER PERMIT FEE <br />'" ��-: ; CATCH BASIN PERMIT FEE <br />� ���� � TOTAL SEWER PERMIT FEES <br />(7) MON7HLY SEWER CHARGES: <br />-. SEWER CONSTRUCTION <br />ao= <br />0 <br />� <br />TRUCK b <br />LATERAL <br />SEWER SERVICE <br />;.;APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />, � , <br />,t�.J::�. <br />' ,;,;':INFO COMPILED BY: <br />� .APPROVAL: <br />na� <br />CHART <br />DATE <br />DATE <br />0 <br />,_ .,..,.,__... , ...._ _.. . ,. . �. —. . <br />. .. . .... .��,�:.�. .... <br />..•r:.'�a� .n'�.- - . � .. _ . � . , . �:�^.c . _. . . . ... . . .. ., . . . . . . . . <br />