Laserfiche WebLink
BLJILDI\G PER\fIT INFORr1ATION � <br />F.11DRESS �?SD cT �/�- �J���� <br />TYPE OF BUILDING ��-/. v�C�N �DATEy-Iy-71~ <br />¢SZ,ou <br />1) BUILDING PERMIT FEE $ ��c q� <br />(A) PLAN CHECI{ FEE $ �� <br />2j \VATER SERVICE TO BE; PAID BEFORE BUILDING 2!4���,�� <br />PERMIT IS ISSUED S �`�` _ <br />(A) TO BE DETERML�IED BY PLF3G. INSP. Z" INCH <br />(B) EXIS'I�' �/y F.:R �yATER SERVICE, APPL. NO. •��'(_� %4 :��i''j� <br />(C) LOCATION (;�/,t�� (��('i{' /LT !��/ %/. <br />CHART `I'-/� � <br />3� DRI�"E1VAY PERMIT TO BE PAID IIEFOR� BUILDING <br />PERMIT IS I557ED ��L FT. (jr�l�/�y>f';/_D/W (TYPE) <br />TOTALT <br />4) STATUS OF SEti1'ER. CHARGES: �/�� �%�l �Iv� <br />BOND DISTRICT FOOTAGE <br />N, S, E, W. <br />LANDSCAPE NOTES <br />SE�VER CONNECTION CHARGES: <br />TRUNK <br />LATERAL <br />g i`�.CC � � <br />$� <br />/Z24�bc� <br />$ <br />S <br />� <br />TOTAL CONNECTION CHARGE � ' <br />SE�VER PERMIT FEE $ �U. c9 rJ <br />GATCH BASIA' PERMIT FEE �/�IIU�� <br />� <br />TOTAL SER'ER PERMIT F�.����_ "�'• �-' c� _ <br />5) MONTHLl SE�VER CciARGES: �: C �/ ' — <br />SEWER CONSTRUCTION: <br />TRUNK <br />� LATERAL <br />SE�VER SERVICE: <br />LOCATION OF SIDE SEWER OR TEE IN THE MA1N: CHART <br />� � 57C/,% /i✓ n�,Q/r4/ �%%�'/X �'�' �_�O_ <br />'�� ) Y � <br />iNFO COMPILED BY: <br />REVIEW: <br />��APPROVA <br />$ -- <br />$ J�'/��',�'F� <br />J - ��� a�- s- <br />// t�f�l%' , i'� <br />� � i�%P:-7c� DN (�IUC� /'7 � � <br />�This total must be paid Uefor- ti�iilding perm:t is issued, <br />j��;i�tr <br />DATE -1-,,!(- 7f <br />DA T E ' � � %`� <br />DATE V 2 �J' <br />