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',.'OR Ci'1'] U`i'� Ui]i,Y ` • • <br /> � <br /> IiNCIiJliERING A[JD COP1[•fONITY SERVT.CES <br /> IIUILDING PERMIT INFORMATION <br /> ADDR�SS � �� �� i r, `% �vrr 1/(/, 7'YI�E � {�. l�. <br /> 1) IIUILDiNG PER".1IT FGE $ I ?��� <br /> (A) PL71t7 CIIECK FEE $ � SO <br /> 2) PLUMBI*.9G $ 'z3 � <br /> 3) MECfI7�NIC1�L $ //o -- <br /> 4) ?'dATER SERVICE TO BE PAID BGPORF. BUILDING ^ <br /> PERniIT IS ISSUED ' ��%�� F _ <br /> $ 2_a o <br /> (A) TO IIE DETERMI:�IED BY PLBG. INSP. �1`F �� INCH ' <br /> (R1 �XIST. RdATER SERVIC�, APnL. NO. j <br /> (c) APPROX. LOCATIOtd Bt' C,2 f�s�,r( 25 � 2 asr <��Z;3 Av� w. ' <br /> S�E�u�� � 3�' � f(, r , cy oF , r� � r,,,,;; ! <br /> r' n;�;rit �y -Co���� Co� �-' ( -7 ' W or CHA?2T 1/1 -�� � _ ; <br /> Tf!R � /1( l� C�f- � t.Tl�:.� i <br /> 5) DRIVEi•I11Y �P�RTIIT TO B� P71SD IIEFORE BUILDING <br /> P�R'�1IT IS ISSUED Z y , I'T. p }-} D/4T (TYPE) 5 � Z , 5� j <br /> G) STATUS OF SE[VER C[IARi�ES: TOTAL $ <br /> BOND -�DISTRICT � � FOOTA�;'r; :, <br /> Nr S� E, i'J. �� <br /> NOTES SS[PER CONN�CTION CHARG�S <br /> ' yrpR � � TRUVK $ G�b _ <br /> �7 /D,�, �7 LATERAL $ <br /> i;r� <br /> TOTI�L CONDIECTIGN CHARGE$_�J C' — <br /> SE�•,'F•.R PER�IIT F�E S�) — <br /> CATCH 9ASIN PERPIIT F�� $ —' <br /> ��1���- �" �� <br /> TOT11L SEi•?ER nERI4IT PEES$ ?j(� ^-- <br /> „ �99� - I <br /> 7) `40NTHLY SE[•TER C[IARGES : ' ' <br /> � <br /> SE[9ER CONSTRUCTION: 'PRUNK $ I � I S <br /> LATER.AL $ <br /> SE`^1ER SERVICE $ Z, S G <br /> i <br /> APPROX. LOCl1TI0N Or SI�P uEWE't OR TPE I:1 TIIr n1nIN; �� �x/�,yj,./ Z3R�J` �� <br /> _ �J, - S i �� s����z zs` �0�7 i� r�� ��l � i�1 � � : <br /> -- CHART _ J ' J S" Z�f-�_ <br /> f fi <br /> INFO CC.,2iLED IIY: /��s•'e.'��,,o+ /`,-''t ..c.� .� DATE "�?,t', .> .�� /�~�� j <br /> r� a <br /> � f�`-7 <br /> APPROVIIL�: D71TE <br /> -R <br />