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i 1 <br /> �? 1 �:� <br /> Y <br /> BUILDING PERMIT INFORMATION <br /> ADDRE55 ��21 UP�.Ar._o� �v� TYPES"'"-����'-Y lC�s-- <br /> e� �-cxf-O O <br /> (1) BUILDING PERMIT FEE �''1l�'L ��' � b Pp µ ZQ��� <br /> (A) PLAN CHECK FEE �Q 0O <br /> (2) PLUMBING 3(�.p0 <br /> (3) MECHANICAL <br /> (4) WATER SERVICE TO C3E PAID PRIOR TO BUILDING PERMIT ISSUANCE �-00• Dc� <br /> (A) TO BE DETERMINED BY SLDG INSPECTOR �— INCH � ��u S��'Y <br /> (B) EXIST. WATER S�RVICE, APPLICATION NO. _.�. <br /> (C) APPROX. LOCATION 4'� <br /> MAiJ �PP2ox- IZ P7 S �'T- <br /> �, o� tz� � CHART K• 3�•Z9• d-- <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PE�tMIT IS- 2Q � � <br /> SUANCE �—FEET � DRIVEWAY(TYPE) 3 �qs, � <br /> 3 <br /> p) STATUS OF SEWER CHARGES: <br /> BOND �T _DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES • <br /> �'�w s�j rx S�-u�esu �-� <br /> o�o u�i-8� <br /> �f'2� 22�. eo <br /> �-YL S F�4•o 0 <br /> 8 � � .eo <br /> SEWER CONNECTION CHARCES <br /> YEAR g� _TftUNK 3 z70'�� <br /> � LhTERAL �S� � � � <br /> I TOTAL CONNECTION CHARGES R -1- z O • U` O . <br /> SEWER PERMIT FEE 5 � �" �� <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES � — 3O' �� <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK � <br /> LATERAL � <br /> SEWER SERVICE <br /> APPRO�. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: 8� MAr^' t��°r�x �Lu <br /> �.p't Tu P�L. �i"2eK '�S Pl" � OF M.L1. l5 ' P-PT�+ � <br /> CHART �` '-�`�'ZQ' 4" <br /> INFO COMPILED E3Y: DATE <br /> APPROVAL: DATE <br /> 5 84 <br /> . .... . . . . . . . F � , ;i <br />