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DEPARTMENT aF COMMUNITY DEVELOPMENT SERVICES <br /> , <br /> BUILDifNG PERII�IT INFORMATION <br /> ADDRE55 �''�' 1 \I�Znc--�-�-+�- �,C-la�;� S ��A TYPE _ S � � <br /> (�) 3UILDING PERMIT FEE �3�3, f�a0- n' S 2'Z`�• ��� <br /> (A) PLAN CHECK FEE - � <br /> (2) PLUMBING �� ' � v <br /> (3) MECHANICAL � Z' �U <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��'�U <br /> (A) TO BE DETERMINED BY DLDG INSPECTOR � INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION '�-_ •o�-lTtc �'TY Z�� <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SUANCE � -1 FEET ��'ti�= D2IVEWAY(TYPE) S �' � <br /> g 3Z.3 �Z� <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND �..�� DISTRICT FOOiAG[ <br /> N, S, E, W <br /> NOTES <br /> SEWER CONNECTION CHARGES <br /> YEAR �Z- TRUNK S Z J�' • �� � <br /> LATERA! <br /> TOTAL �ONNECTION CH�RGES S Z-��" � �� - <br /> � <br /> 3 ) <br /> 5[WER PERMIT FEE � $ ��- E d <br /> CATCH BA51N PERMIT FEE '�' '�`'l8� � <br /> TOTAL SEWER PERMIT FEES $ '3� `C� <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE � � <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: L/�'T %v f�� bP�i�c='k. <br /> � �--r /.0 ��,� �� r= � F,,�, �F- G o T � n�vc�. �f-� a-r.� <br /> CHART t�--/ Z` Z�'l u <br /> INFO COMPILED BY: _ DAT[ <br /> APP�:OVAL: DATE <br /> 9.149 <br />