Laserfiche WebLink
. � <br />ADDRESS_ <br />T1 PE OF B <br />BUILDING PERMIT INFOF.MATIGN <br />_ // � �� J%• ✓ �L% r <br />�T <br />1) BUILDIN'G PERMIT FEE <br />(A) PLAN CHECK FEE <br />�, <br />2) P�ATER SERV?CE TO BE T�AID BEFORE BUILDING <br />PERMIT IS ISSUED <br />(A) TO BE DETERMINED BY PLBG. INSY. `S � INCH <br />(B) EXIST. _ WATER SERVICE, APFL. NO, <br />-i� <br />�c� LocAziorr � C', I l_� �.� r�-� i�v v 9�`� S%. <br />CHART �Lb— 5 � <br />3) DRI\"EWAY PERMIT TO EE PAID BEF '�'.E BUILDING <br />PERb4IT IS ISS�JED /S FT. ;15�'//IL. D/W (TYPE) <br />�ATE /-.�/-7.5- <br />� /G�f.a v <br />$ ��. SU <br />$ �(^v.C9 O <br />� �7 SU <br />TOTAL'= $ U�CC�, • O d <br />4) STATIJS OF SEbVER CHARGES: <br />BONil DISTRICT FOOTAGE <br />N, S, E, W. <br />LANDSCAPE NOTES <br />SEtiVER CONNECTION CHAP.GES: <br />TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGE <br />SEWER PERMIT FEE <br />CATCH BASIN PEF2N.IT FEE <br />TOTAI. SEWER PERMIT FEES <br />5) MONTHLY SEWER CHARGES: <br />SEWER GONSTRUCTICN: <br />T RU I3K <br />LATER.AL <br />SEWER SERVICE: <br />$ <br />$ <br />E� <br />LOCATION OF SIDE SEWER OR TEE SN THE MAIN: CHART <br />�� Ct!E���' �L� �/7L�f�il;i/---1�� � S�� L.�irlic� 7,4;�=D i�- S-7� <br />INFO COM'r'ILED BY <br />REVIEW: <br />APPROVA <br />� <br />c. <br />'� This total must be paid before building permit is issued. <br />DATE ,�?-f�`,- <br />DATE z-"�-'-'.- <br />DATF,� -���Z`J <br />