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. <br />ENGINEERING DEPARTMENT <br />BUILDING PERMIT INFORMATION <br />ADDRESS `��� — ;�/� '� � LGJ , TYPE .5 r • �o . <br />1) BUILDZNG PERMIT FEE /�� ;�Ic�(o•`=a $ '_,r �� c�a <br />(A) YLAN CAECK FEE $ -�q,o� <br />2) WATER SERVICE TO BE PAID BEFQRE BUILDZNG <br />PERMIT IS ISSUED <br />(A) TO BE DETERMINED BY PLHG. INSP. •3� INCH <br />�+--- <br />(23) EXIST. WATER SERVICE, APPL. IvO. <br />S vt0� �o <br />(C) APPROX. I,OCATION / . w7.�,�p. ,3�.f�. ,�,� �;.=� � .1,n��-�� ��� <br />D?�t C� C./, Z.S�S .� _`:%i-r"�/��. CHA T (r <br />�— �¢-� <br />3) RIVEWAY PERMIT TO BE PAID BEFORE BUILUING <br />PERMIT IS ISSUED � FT. CL�. D/W (TYPE) $ �.'3.G�i� <br />TOTAL* <br />9) STATUS OF SEWER CHARGES: <br />BOND ..7L DISTRICT /� FOOTAGE `�-" <br />N, S, E, W. <br />;-r`r- �4°- � <br />SEWER CONSTRUCTION: <br />SEWER SERVICE: <br />�,�.�5! �y �..� <br />T <br />ZNFO GMPILED SC: <br />REVZEW: <br />APPROVAL <br />SEWER CONNECTION CI�IARGES: <br />YEAR � TRUNK <br />C Tr � H �R E <br />TOTAL CONNE TION G A G <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEL' <br />TOTAL SEWER PERMIT FEES <br />OF SIDE„SEWER OR TEE IN <br />TRUNK <br />LATERAL <br />$ <br />$ �� L,'�i•��. <br />� . .��.� <br />S <br />S /�%,� 00 <br />$ � O. L�� <br />$ c_ <br />$ � �S <br />& � • �� <br />. s. s _ _/39'k-! o � <br />� <br />DATE <br />DATP•. 3-������ <br />* This total mest be na;c� hafnrA h,,;i.�;.... .,,.�.,.:� :.. ....,.....� <br />