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nnnar•.ss <br />131]1L.AING PI•:RM1T TNI'ORMA'I'IO;V <br />�iA7' c �.—.�.-cr <br />TYPE OI' IIUILDING�_�_ <br />1) P.UII.nING P].RMIT I'�L ,�� �- <br />(A) PLAN CI1�C1{ F'L� <br />2) l':,;7 1:It SI�R\rIC7: 'I'O I�I•; 1'All.) I3EI� ORL ISUILllING <br />. Yr RAf11' 1S IL'SUI:ll <br />�y�-�.� <br />y� <br />�a�' � y3 <br />----• DAT1; l-'-/�-%G <br />n � ��4 �� <br />�Gl. 2,�p��' �� 07� <br />-�, <br />� ��iv.C�) <br />�::) '!'U I;li DI;'1'L•'12,�fID:i•:U AY FLIIG. INSP. .�l INCIT - <br />�) IiXIST. _ \5'ATER SL•'RVICF, APPL. NO. <br />(C) LOCATIUN � �" L' /• .i�� �,j�>Jf' �� � • <br />�ifITE 5"Ti�cT C�IART�-/03 <br />3) Di IV�PIAY YEi:?.11T TO 13E PAID II:FORE llUII.DIXG <br />Y'c.R\111' IS ISS�JL•'D --FT, D/1Y (TPPE) g—�— <br />�GCed�J�2d9�aG2�'!/� S �i�- <br />T(�iAL <br />9) 57:�1'US OF SE11'F;R CIiARGES: ,� — <br />liOivD _DISTRICT I'OOTAGE�2'�"'��"{ <br />N, S, .E, \ti'. <br />SE\1'LR CO:I\ECT1C\' C�L4RGT:5: <br />TRU\3{ <br />LATEIZAI. <br />TOTAL CO\NL'GTIO�I CIi1P.G� <br />SL•'\7ER PF.I2\f1T F?'E <br />CATC2I BASIN PER\fIT FEE <br />TOTAL SE�1'ER PER\-fIT FEES <br />5) \;OV'I'FILY SEl1'�R CH.4RGE5: <br />�FWER CONSTRUCTION: <br />TRUi�I{ <br />: � � LATERAL <br />, ��1� SEIVER SERVIC�: <br />�U' �',�. <br />J <br />$ .-�__ <br />5 �— <br />s ���. GD <br />S <br />g �G' • DO <br />S --- <br />� � •SC' <br />li� LOC:ITION OI' SID� S�1V�R OR TEE IN• THE D�fAIN: CHART,rt'-,�G - <br />/. ��T � �l/ � �e. ;�%f� � /�fti S% t' ��//t <br />a'=..�� ,. <br />i.rc cc <br />r.i:�•iLn� <br />AYP1:(�V' <br />�. ��i !� <br />. , �t <br />nnTr•_ <br />DAT� <br />7l,is f�4,il nni:;l hc pair3 bcfarc buildinr permit is issurd. <br />DA'fE "�1��v <br />