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. ...>.... . � '1.....�i . • . . ' . <br /> � �.�1� <br /> tj ti. <br /> - DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br /> BUILDING PERMIT INFORRAATION <br /> ,\DDRESS ��.Z�'�"�C I� • TYPE �' ��� <br /> (1) BUILDING PERM.IT fEE j��.9� ' � $ �¢� � <br /> (A) PLAN CHECK FEE ��''Z'r <br /> (2) PLUMDING Z � • Bv <br /> (3) MECHnNICAL �y7��- �s � � � <br /> (4) WAT[R SERVICE TO E3E PAID PRIOR TO BUILDING PERMIT ISSUANC[ ¢00 . C9U <br /> (A) TO BE DE'fERMINED BY E3LDG INSPEC70R_�_ INCH <br /> (B) EXIST. WATER SI:RVICE. APPLICATION NO. <br /> (C) APPROX. LOCnTION 4'� e�a.� .aJ ' �t�' E�-�-T <br /> Lni�. �/to-t� uaJK.��d'�-� CHART �� �^ 28 !� <br /> (5) DRIVEWAY I'CRMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- 2O � <br /> SU�NCE FEET DRIVEWAY(TYPE) S <br /> S <br /> (7j STATUS OF SEWER CHARGES: <br /> 80ND �DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> .��u�ra ��v. �� � <br /> o.� p8�-Bs <br /> S.,r'�Q 8-pp, � <br /> SEWER CONNECTION CHARGES Z� O, lJ� <br /> YEAR �� TRUNK S �D � <br /> LATERAL � <br /> TOTAL CONNECTION CHARGES � �ZD. 6� <br /> SEWER PERMIT FEE $ 3��� <br /> CATCH BASIN PERMIT FEE <br /> TOTnL SEWER PERMIT FEES $ <br /> (7) MONTHLY SEWER CHARGES: <br /> SEV�'FR CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOC�TION OF SIDE ;EWER OR TEE IN THE MAIN: h�'�`� �� �T N � <br /> scL �t E" ce,e s� Lo r �c. o,enr 7 "�7�7'• �_ ��¢ -- <br /> CHART �� <br /> INFO COMPILED E3Y: DATE <br /> APPROVAL: DATE <br /> s a+ <br />