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�"s'wi4S\YR!Yit..s�iASqLII�l�A6JY�li�If5���4'. <br /> I <br /> UEPARTMENT OF _'OMMUNITY DEVELOPMENT SERVICES � <br /> � lJG �.?�INC PERIVi1T INFORJl�1�47'10{� <br /> ALDRESS ��L� � �x� 5T. TYPE �'�'� _ <br />' (1) BUILDING PERMIT FEE l��oi��- a d S � �� - �6 <br /> (A) PI.AN CHECK FEE -- <br /> i2) PLUMBING z� " � d <br /> ;3) MECHANICAL 8 ��'`' <br /> (4) W,4TER SERV!CF `O BG PAID PRIOR TO BUfLDING PERMIT ISSiJANCE 2 3 s- �rr� _ <br /> (A) TO [iE DET RMINED BY BLDG INSPECTOR ��� WCH <br /> (Bj EXIST. _ \NATER SERVICE, APPUCATIUN NO. <br /> (C) APPROX. LOCATION �" G• -_ /�-n A c,U ,d.P,o,i�x Z�,�-- ��- <br /> � oa D� �o►�CHART 5- S� <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br /> SIiANCE �_ � � FEET �SPtd�G.7 DRIVEWAY(TYPE) � 7' S� <br /> $ 4� o _�o <br /> (7i STATUS OF �fWER CHARGES: <br /> B(�vD DISTRICT FOOTAGE ��'2Jffc�J/� • <br /> N, 5, G, W <br /> NOTES <br /> SEWER CONNECTION CHARGLS <br /> YEP,R __TRUNK S <br /> LAT[RAL <br /> TOTAL CONNECTIUN CHARGES R <br /> SEWER PERMIT FEE S 3O '0 � <br /> �----• <br /> CATCH BASIN PERMIT FEE _ <br />, TOTAL SEWER PERMIT FEES S —���— <br /> (7) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRUCTION TRUCK S � <br /> �, <br /> LATERAL <br /> SEVVER SERVICF � � <br /> APPROX. LOCF.TION Of SIDE SEWER UR 1'EE IN THE iV1AIN: 3Co" N>Ar.�J � �� <br /> ��G/AN/7 .� J E [��EE j U N1,O l tJ .A�vo26k ��F'7 �P'� <br /> �d/'I. f�, �x.�.i � -r/z!� �T CHART� �-Z4-'� <br /> Y- <br /> INFOCOMPILEDBY: _ DATE ..— <br /> APPROVAL: —_ _ 7ATt — <br /> 5,�» <br />� , <br />