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r'"r � <br />DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br />BUILDING PERMIT INFOR�IAATION <br />�.a� �y8 <br />ADDRESS 7'!� A` � SS ru S,r. S. W <br />(1) BUILDING PERMIT FEE 80� Ol9�•� <br />(A) PLAN CHECK FEE <br />(2) PLUMBINC <br />TYPE C e �''Lr'''� <br />g Zd'1. °� <br />Po. �' dA.ua <br />3in -C�D <br />(3) MECkANICAL 2Ca •6a <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUhNCE LD '� <br />(A) TO BE DETERMINED BY BLDG INSPECTOR I INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION ��'Nt.�-u svArsay. L�` r-� oC ?s 9� fZ�W• <br />GJC��dldo ?o � MNae� 3� �i o a l�t •t �oa <br />CHART W - S S� _ <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE 2S FEET C-d�C• DRIVEWAY(TYPE) $ �2'�� <br />g 3�[.St� <br />(7) STATUS OF SEWER CHARCES: <br />Bc�ND �DISTRICT �- FOOTAGE �S <br />N, S, '� W <br />NOTES <br />SP�cac. ��e C'rr�,ac�s p� 4.v �G9- 80 <br />/�?.�r� '� 5 � � 50. oa <br />SEWER CONNE�TION CHARCES <br />YEAR g� TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES � <br />�� <br />SEWER PERMIT FEE �/� <br />CATCH BASIN PERMIT FEE "'`6���� <br />TOTAL SEWER PERMIT FEES <br />$ J�02- Od <br />5 3�_ o� <br />g '• -�O <br />(7) MONTHLY SEWER CHARGES: .h <br />SEWER CONSTRUCTION TRUCK S G�2 `'�� <br />LATERAL <br />SEWER SERVICE /��'``�"''' <br />,4PPROX. LGCATION UF SIDE SEWER OR TEE IN THE ��1AIN: � uE3Bc� 7o P�� - <br />bi�P�BY !S FT S o� N�.E c_oa. l.or � bPr�em,� c..Q�r "D�o <br />CHART �- �'-�b''4 <br />INfO COMPILED BY: . DATE <br />APPROVAL: DATE <br />