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L � <br />OE►A�TMENT OF COMMUNITl� DEVELO�MENT fERVICES <br />BU�LDING PERMIT INFORMATIOId <br />ADDRESS ��7'� ��PTr� �JT. S �L.lJ� TYPE � ��/4c-G �iuf K.�S <br />(1) BUILDING PERMIT FEE ��7 BQm• � . S �[t�4.OlJ _ <br />(A) PLAN CHECK FEE � �� � nut= <br />(2) PLUMBING 2 �• d� <br />(3) MECHANICAL . �� `�� <br />(4) WATER SEP. � ICE TO 8F pAID PRICR TO BUILDINC PFRMST ISSUANCE ��� �v <br />(A) TO BE DETERMINED BY BLDG INSPECTOR _� INCH <br />(B) EXIST. WATFR SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATIUN �J" 7/.eav_�-�o 'Z�J P��- ,9!'/l.�.r <br />�� �� GaT <br />� Fr � Or l�-Q.� . CHART G-��l�- 3- 2�3 -�-� <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE _ FEET DRIVEWAY(TYPE) S <br />3 <br />p) STATUS OF SEWER CHARGES: <br />BOND � _DISTRICT <br />NOTES <br />�zt�L.L-� Z�e_-v', j-'"�� <br />t�,rzn !/7/- ��� <br />�•F; �=s• <br />��v -�22¢•°= <br />FOOTAG E <br />N, S, E, W <br />SEWER CONNECTION CHARG�S <br />YEAR `�j TRUNK <br />LATERAL <br />TOl'AL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMI? FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />SEWER SERVICE <br />APFROX. LOCATION OF SID'c SEWER <br />INFOCOMPILED BY: <br />APPROVAL: <br />5•84 <br />TRUCK <br />LATERAL <br />TEE IN THE MAIN: �?� <br />�6' �nn.o,c � r <br />2 � <br />b <br />5 <br />5 <br />3d-dU` <br />b �p '� <br />b <br />r �r�J .� i i �•--- <br />CHARTU�aFJ� 3-2E'--4- <br />DATE <br />DATE <br />