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� DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br /> �3 �JlLDING PERMIT INFORMATION <br /> ADDRESS 5d(o 'J`�zn`'`�`: WA�{ 5 GJ --TYPE �'F''e' <br /> � 5�l,UOU. oJ g �89•a� <br /> (1) BUILDING PERMIT FEE ��o ,� �G/�,� <br /> (A) PLAN CHECK FEE 2� ov_ <br /> (2) PLUMf31NG 2 ,��-- <br /> (3) MECHANICAL ��,QU __ <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERM�IT ISSUANCE <br /> (A) TO BE D[TERMINED BY DLDG INSP[CTOR _.—W—INCH <br /> (B) EXIST. WATER SERVICE, APPLICATIOIJ NO. <br /> (C) APPROX. LOCATION .`J7���3r�� TD '�i� c�''' � Lor4� <br /> Qts.�� A!•E Lae oF GoT CHAR7 �-/�-�S-d <br /> (5) DR1�'EWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- 2� a J <br /> SUAN(:E FEET DRIVEWAY(TYPE) S <br /> 5 <br /> (7) STATUS OF SEWER CH�RGES: <br /> BOND � DISTRICT FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> � <br /> SEWER CONNECI'ION CHARGES �7O o� <br /> Y.AR �3 TRUNK 3 <br /> LATERAL �. 7�3��� 9 l - <br /> z �o .va <br /> TOTAL CONNECTION CHARGES 5 <br /> SEWER PERMIT FEE a��0�"' S �'�U <br /> CATCH BASIN PERMIT FEE — <br /> TOTAL SEWER PERMIT FEES b �--' <br /> (7) MONTHLY �EWER CHARGES: � <br /> SEWER CONSTRUCTION TRUCK <br /> LATERAL <br /> SEWER SERVICE <br /> 67ci Bl3—» TO P/� D!�l�CFk <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: , <br /> i[� �'� G �� ,cr' v��P ��- L 17_L�a .o oP.ea� 9E> r��-z�'- <br /> CHART �= - �Z- 7'o-G" <br /> INFO COMPILED BY: C�TE <br /> DATE <br /> APPROVAL: <br /> 9.1J9 <br />