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9 <br />� <br />J <br />DE►ARiMENT OF GOMMUNITY DEVEl01MENT SERVICES <br />BUILDING PERMST INFORMATION <br />ADURESS ��YQ �Z��7 `r. TYPE h• f"-e- _ <br />(1) Bl'ILDING PERMIT FEE �,.�- �`� b 2�5�� <br />(A) PLAN CHECK FEE 48.75 nr,tE <br />(2) PLUMBING �d' �� — <br />(3) MFCHANICAL ��� � <br />(4) WA1 ER SERVICE TO BE PAID PRIOR TO BUILDING PER IT ISSUANCE 2 3��, � <br />(A) TO BE UcTER!vi!NED BY BLDG INSPECTOR_�_l�JCH <br />(B) EXIST. __ ::ATER SERVICE, APPLICATION NO. <br />(C) APPROX.LOCl�TION.�"G.2 wnn�•� �,vp¢�� Or�r <br />S o-� �, ca= ZIs �_Sr. t?.�iftBiART n-t - Sf� <br />(5) DRIYEWAY PERMIT TO BE PAID PRIOR TO BUILDlNG PERMIT IS- <br />SUANCE <br />FEET <br />(7) STATUS OF SEWER CHARGES: <br />BOND <br />NOTES <br />DISTRICT <br />5 PEf.� Ol� �Gw E� �= !*�eybS <br />�20 laCv4- F�O <br />.- . <br />�'✓- �� �-�. 221. ou <br />DRIVEWAY (TYPE) S 0� �' ' �� <br />E 5 2 (P. 75 <br />FOOT�CE �o�tf ��� <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PF.RMIT FEE ��j�"7J <br />S <br />S <br />b �O.O b <br />-�- <br />TOTAL SE�NER PERMIT FEES 3 �'�v <br />(7) MONTHLY SEWER CHARCES: <br />������ <br />SEWER CONSTRUCTION TRUCK 3 '' <br />LATERAL <br />SEWER SERVICE �=�� <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: ��` Mc-c�� �� ni�_ "' �-�' oG� � <br />-It3 i., ���. .) w=..ni.,. COC7 FT W �i� M. ll..._i ` J LUA[�(,��,�-� <br />�_4d.►e�ax L143pr ���o CHART��'�24__' `LO-z2-S' <br />INFO COMPILED BY: _ DATE <br />ApPROVAI: DATE <br />