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� �� <br /> BUILDfNG PERMIT INFAR:dIAT10B�1 '� <br /> �� J�, �.�-- I <br /> ADDRESS /iL�� �`v� � �p- ��-- � � <br /> (1) BUILDING PERMIT FEE $ ��y�, � <br /> (A) PLAN CHECK FEE --�/"/1��-- - <br /> ��y (2) PLUMBING � I <br /> A�x (3) MECHANICAL � <br /> y y vi (4) STATE SURCHARGES —�j�,�_�"— I' <br /> H �3 <br /> (A) BUILDING CODE ' C <br /> � y� (B� ENERGYCODE � � <br /> '� F"''� (5) DRIVEWAY PERMIT � I <br /> H �t" 5 _� � <br /> z3 - I <br /> � yd I <br /> ��� (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT IS� S]UANCE � ___-�� - � <br /> ay� (A) TO BF DETERMINED BY BLDG. INSPECTOR ____- �I")- INCH I <br /> " (B) EXIST._ WATER SERVICE APPLICATION NO.______-_ .-. <br /> t HH <br /> o �'H (7) STATUS QF SEW�R CHARGES <br /> � �� BOND _.�J�LI DISTRICT_____ ______.. POOTAGE_ ___ _ - -_- <br /> N, S, F_ w <br /> Z H fn <br /> H O fn <br /> ORDINANCE 1171-F35 pD <br /> WATER ���,�--- <br /> .r � SBNER =---�-Z�—�--- <br /> G <br /> TOTAL ORD. FEE _��'-�� <br /> �� SEWER CONNECTIUN CHARGES <br /> �� YEAR -- . _ ---- TRUNK $ --� -- <br /> �� I.ATERAL <br />, TOTAI CONNECTION CHARGES $ � <br /> � <br /> 1,�� � �`�o0 <br /> SEWER PERMIT FE6 � --�x/--.-- <br />' �'= <br /> `r'� <br /> ' �s <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> I <br /> � <br /> I <br />