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DEMRTMENT Of COMMUNITY OE�'ELO►MEHT SERVICES <br />�UILDING PERMIT INFORMATION <br />ADDRESS ��Lvv� �Ti,� ^I�• �.� TYPES�►.�c�� �r1w; ILGS_ <br />(1) BUILDING PERMIT FEE �S�,tI�D'�' � 2qs' dd <br />(A) PLAN CHECK FEE �'�'g�G <br />;2) PLUMBING 2�� � <br />(3) MECHANICAL �'���'� <br />(4J WATER 'iERVICE TO RE PAID PRiOR TO 8U!LDING PERMIT ISSUANCE �P �' �a <br />(A) TU BE DETERMINED BY BiDG INSPECTOR INCH <br />(t3) EXiST. WATER SERVICE, APPLICATION iJO. _— <br />(C) APPROX. LOCATION - <br />CHART --- <br />(5) DRIVEWAt' PERMIT TO BE PAIu PRIOR TO 8111LDING PERMIT IS- <br />SUANCE FELT DRIVEWAY(TYPE) b <br />� E <br />(7) STATUS OF SEWER CHARGES: <br />BOND �DISTRICT <br />NOTES <br />�_ � a .i� .� <br />02lJ 1�171-8� <br />�� t-t4.o� <br />S�u-�'�2 4-t �. o 0 <br />c�b� �o <br />FOOTAGE _-- <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR � 4 TRUNK <br />LATERAL <br />TOTAL CONNECTIUN CHARGES <br />SFWfR PPRMIT FFE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTFILY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />5 33�. o0 <br />g 33�.c�o <br />$ 3D.DU <br />i'RUCK � <br />LATERAL <br />SEWER SERVICL <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED 3Y: <br />APPROVAL: <br />s aa <br />CHART <br />DATE <br />DATE <br />