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� , <br /> .� <br /> BUl�DINC PERMlT INFQRMATION '�ti <br /> ,:��,: <br /> ADDRESS <br /> (1) BUILDING PERYIIT FEE �"T � (;� (� <br /> ' ;�i� S �7 7,�(.1_. <br /> (A) PLAN CHECK FEE ` b�I, 35 - � �C�• S � � �Y __ <br /> (2) PLUMBING �iS �d,/9� <br /> f3) MECHANICAL ��)W <br /> y �H (4) STATE SURCHARGES _ � I _ <br /> � �i y (A) BJILDING CODE �-1;� __ <br /> G � H (B} ENERGY CODE �,., _ <br /> t+ `3 y (5) Dr71VEWAY PERMIT di J,� <br /> K �n S -ls:.cLw <br /> H 7d <br /> � y H ��., <br /> � o� (o) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE S __ _ ._�% S�___ __ <br /> y (A) TO BE DETER�AINED BY BLDG. INSPECTOR�,.�' �___ INCH <br /> � ��y (B) EXIST. WATER SEP.VICE APPLICATION NO. __.__ _ _ _ <br /> H LTl <br /> c�� c� (7) STATUS OF SEWER CHARGES: <br /> � y� BOND. ���,�.ttCo-n'_- DISTRICT ___ _ __ __ FOOTAGE___ _ <br /> z N. s. e. �v <br /> HH <br /> 8 �' <br /> H <br /> �� dC yt+ GRDINANCE 1171-85 <br /> y v�i �;�ATER � '�l ` — <br /> y � y SEWE9 U?/ �' <br /> � TOTAL ORD. FEE _ _�r.��O�' __ <br /> � <br /> � SEWER CONNECTION CHARGES <br /> �� --- - ---- � -� <br /> YEAR __ __ . ._ TRUNK S ___ _ <br /> � - <br /> LATERAL ' ' <br /> TOTAL CONNECTION CHARGES 5 _ <br /> � - <br /> � �� � � <br /> SEWER PERMIT FEE S <br /> � '� <br /> � � � (' 7� <br /> '�{- ��r/-= � �, ���Lr�L.{ �Q�� - ��Cao _ <br /> � ' jy� <br /> � ��� � ✓V�L--� /rtiCr� � � . <br /> � 1_ <br /> � <br /> � � <br /> I CGAL OI SCIIIPIIUN <br /> �'ttiJhYt, '��rl .;:JO tU cVti:Ll l <br /> ULK JU`i �l-q 1 - <br /> ,��h. 5 LUl' 4 L t! h fr-f L(1T �� <br /> �qcf�!:;1 fiJ ACf_.11l'Jf iIJ1 Y�;IH ;,I,iu.•� I.`.�L1L IU:�C) <br />