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� <br />DEIA' !ENT OF COMMUNITY DEVELOPMENT tVICES <br />BUILDING PERMIT INF'OaMAT1�N <br />ADDRESS S�Z� ��UU�� � VE TYPE S��u� �/�LY fZNs <br />(1) BUILDINC FERMIT FEE ��I b�0 •� S �-Z3•S o <br />� pn,� �s�9 <br />(�) PLAN CHECK FEE 4.D•D'a <br />(2) PLUMBING I I ��p <br />(3) MFCHANICAL { <br />(�0 �d0 <br />(4) WATER SERVICE TQ BE PAID PRIOR TO RUILDING PER IT ISSUANCE <br />(A) TO BE DETERMINED BY BLDC !NSPECTOR �— INCH <br />(B) EXIST. _�,. WATER SERViCE, APPLICnTION NO. <br />(C) APPROX. LOCATION <br />CHART <br />(5) DRIVEWAY PERMIT TU BE PAID PRIOR TO BUILDING PERMIT IS- �^� <br />SUANCE FEET DRIVEWAY(TYPE) S <br />S <br />(7) STATUS OF SEWER CHARGES: <br />BOND . � DISTRICT <br />NOTES <br />Ea�L'GI�OL GIT7t.f"tY �c�r <br />b7df�,, l /7/ - By� <br />�/.�� - �t?Y• �- <br />� <br />FOOTAGE <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR � � TRUNK S��� O�o <br />LATERAL ��7� , � S i <br />TOTAL CONNECTION CHARGES s - <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />�•. � TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OF TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />s�ea <br />y 3�.mv <br />s �.Ot� <br />E <br />CHART <br />DATE <br />DATE <br />