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ENGINEERING DEPARTMENT � <br /> BUILDING PERMIT INFORMATION . <br /> ADDRESS � ZII I A�8 �/r� `�/ ' `��TYPE �vPGE.'� <br /> 1) BUILDING PERMIT FEE 7jU�(7�-�� $ 1 � ' � <br /> (A) PLAN CHECK FEE• S �O 3•�— <br /> 2) WATER SERVICE TO BE PAID BEFORE BUILDING g�,pp OD <br /> 'PERMIT IS ISSUED <br /> (A) T7 BE DETERMINED BY PLBG. ,INSP. � INCH <br /> (B) EXIST. ' WATER SERVICE, APPL. N0. �— . <br /> pi <br /> . (C) APPROX. LOCATION G �� C�•� — I/ N. <br /> �9�`b Q�r�f � � � cx�xT L-20� <br /> 3) DRIVEWAY PERM::T TO BE PAID BEFORE BUILDING <br /> PERMIT IS �SSUED'?-/� FT. �Q D/W (TYPE) � $��. OD <br /> TOTAL* $ �✓ ' S� <br /> 4) STATUS OE SFWER CHARGES• i <br /> BOND_,Z� DISTRICT� FOOT�IGE ��� , <br /> S, E, W. ` <br /> ' NOTES SEWER COJNNECTION CHARGES: <br /> YEAR /G� TRUNK $ ���• DO <br /> 3�(� - oos - o ( s 5p�00.A�0 <br /> r TOTAL CONNECTtO� C G�r S 4 ��' ."'�/ �Z' �� <br /> SEWER PERMIT FEE S � � <br /> �: <br /> CATCA BASIN PERMIT FEE $ —� <br /> . TOTAL SEWER PERMIT FEES $ �'"�� <br /> 5) MONTHLY SEWER CHARGES: <br /> SEWER CONSTRllCTION: TRUNK $ � a �/ <br /> iATERAL $ 3 �PD _ <br /> SEWER SERVICE: - $ ��e�G�G�'/ <br /> � APPROX. L1OCATION OF SIDE SEWER OR TEE IN THE MAII�: c� '�/S Od� � ��'• <br /> f'� ST. � A//u C!,/ O� S.��� '�Y/SJf / i_^�m !'/•.. . cs ��� 0�+� <br /> • u F«..� e� .5�.t � CHART - '7. --� �` _ <br /> i^ i/ <br /> INFO COMPI7JE� BY: ,� ' � DATE��,�.�� <br /> REVIEW: V / 1. I) [� DATE <br /> PROJECTS DIVISION <br /> APPRQ`IAL: �r��/` DATE� . <br /> ENGINEERING DEPARTMENT <br /> * This tot.al must be paid before buildinq permit is issued. <br />