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ADDRESS <br />(1) BUILDIN3PERMITFEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBIN6 <br />(3) MECHANICAL <br />' (4) STATE SURCHAHaES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY � "�1MIT � <br />, `�2 .."i ` '', • <br />FOR OFFlCE USE ONLY <br />. <br />(6) WATER 6ERVICE 70 BE PAID PHIOR TO BUILDINO PERMIT ISSUANCE <br />, : . (A) TO BE DETERMINED,BY BLDO.�INSPECTOR ' � '� � INCN <br />'; ` (P) EXI31;' ' ' ' WATER 6ERVICE,'APPLICATION NO. <br />(' .STATUS OF SEWER CFIABOES: ' ' "' <br />. , , , . , , ,��� ,: � <br />. BOND "�• � DISTRICT�' " ' ' ' �'� FOOTAOE <br />.. . . . . . . . . • � N� $ E� W <br />. i � . � . .. ,. :�r ,. � i: .. i. ;+��. <br />SYSTEMS DEVELOPMENT � <br />. ' WATER. <br />... . . . SEWER.. <br />. , � ,. .. TO7AL ORD. PEE <br />.. ; ,.�i,•i i� <br />�ii, i t .�.:.e��b._�.: .. '. <br />. . � . ... . . .:� 66VYER CONNECTION CHAFOES j <br />� inr., <br />" , .� YEAR, TRUNK '. <br />� . . •' �'LATEHAL :.. _ <br />� i�,.., ���.. � <br />' ' ' . ' � JOTAC CONNECT�ON CHAR6ES <br />� .. . ._ :kii.:ii'�i:i��'i: . . . � . <br />. . ' �..,i:,'i�:,�.i�,cr':::.�'�.�:�;SEWERPERMITFEE :. <br />, , �- <br />. . .. .. . ,1i� , i�.�,. . . _ . _ . . . <br />. _ . . �,.��. � .. �. <br />I <br />S <br />F /G s <br />; .. . � <br />� <br />5!v'� <br />� y�� .. � <br />