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�- -� <br /> -. . <br /> '�, <br /> DEPARTMENT OF COMMUNITY DEVELO►MENT SERYiCES <br /> BUiL�ING PERMIT INFORMATlO�I <br /> n p .� �1 � /� - <br /> .'DDRESS _s� / �.<<x :" �• L.G�z�, -�!. �U - Tl'PE � <br /> (�) J3UI1-71NG PERMIT FEE y�j; D �a <br /> °`�— $ o?S,6 `- <br /> !A) PIAN CHECK FEE <br /> - (2) PLUMBING �� � <br /> (3) MECHAt�'ICAL �-�c <br /> (4) :""?:it ScRVICE TO DE PAID PRIOR TC� BUILDING PERMIT ISSUANCE �n � <br /> �A) TO BE f�ETERMINED 8Y BLDG 'NSPECTOR . INCH <br /> (8) EXIST. ��_ WATER� SERVfI �7 APPUC yT1Gt ' �— <br /> ;i,%l i�./. . ���� �z_. <br /> (C) APPROX. LOCATIS�h�" �--� - � ' <br /> CHART ..___ <br /> (S) DRIVE1niAY PERMIT TO DE PAID �!'I�IOR TO B.�U.ILDINC PERMIT IS- � . <br /> SUANCE � � FEET ��'� nRIVEWAI'(TYPE) � L•� p„ <br /> g 36d � <br /> (7) STAI'US OF SE`v1'EK :.�1ARGES: <br /> BOND � DISTRICT —_FOOTAGE <br /> N, S, E, W <br /> NO' C`, <br /> SEW[R C+��+NEC710N CHARGES � <br /> YEAR __ TP.Uhk S ��Z2�' <br /> I.",TFRA:. , ---�— <br /> TOTAL CONNECTIc1N CHARGES 3 � �Q <br /> � <br /> SEWER PERMIT FEE � -�D <br /> CATCH BASIN PERMIT FEE --�--- <br /> TOTAL SE�VER PERMIT FEES $ � d <br /> (?) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK b <br /> LATERAL <br /> - SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SE�'VER OR TEE IN THE MAIN: <br /> CHART� �a' ^8-� <br /> � : <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> o.t.�a <br />