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, <br /> BUILDING PERMIT INFORMATION <br /> �0 vlc�i v'f�ts,�'r I-}VE TYPE JlA+�alJt �• IC.��S <br /> ADDRE55 2 �' s .�T�.. SO <br /> (1J BUILDING PERMIT FEE q�t�� ' � ZCt,Z•,S <br /> (q) PLAN CHECK FEE - 1O , v0 <br /> (2) PLUMBING "Z(p.S� <br /> (3) MECHANIC .L Lo�• <br /> (41 VVATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUiNCH <br /> (A) TO BE DETERMINED BY BLDG INSPf CTOR�-- <br /> (B) EXIST. — WATER SERVICE, P�PPLICATION NO. <br /> C bf 1�4.W <br /> (C) APPROX. LOCATION �X' � � <br /> (�R, �_CHART `I� . 2./�B .�I- <br /> (5) DRIVEWAY PERMIT TO B[ PAID PRIOR TO BUILDING PERMIT IS• 2� � O� <br /> FEET �----DRIVEWAY(TYPE) 3 <br /> SUANCE ----- � <br /> (7) STATUS OF SEWER CHARGES: FOOTAGE _.-- <br /> BOND �-DISTftICT _-- <br /> N, S, E, W <br /> NOTES <br /> s��.�_ U-��,-� �--� <br /> oa.r� ��,�-�5� � <br /> u,,a. ;���.. n� <br /> SEWER CONNECTION CHARGES � �pT ��� <br /> YEAR 8� TRUNK E �� � a�— <br /> LATERAL f LITI-B� <br /> TOTnL CONNECTION CHARGES <br /> s 'J��• �O <br /> SCWER PERMIT FEE <br /> CATCIi BASIN PERMIT FEE � 3D, �d <br /> TOTAL SEWER PERMIT FEES <br /> p) MON7HLY SEWER CHARGES: TRUCK s �— <br /> SEWER CONSTRUCTION <br /> LATERAL <br /> SEWER SERVICE c� p-f VU _ <br /> APPROX. LOCATION OF SIDE SEWER O; TE�N�T�MA��T �� <br /> bF �e C- O� � nr � '�" 2' ^l8 '�- <br /> __�_ CHART <br /> DATE � <br /> INFO COMPILED BY: DATE <br /> APPR:�VAL: <br /> s ea <br />