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1 <br /> _ ENG" ;�EE-:II3G DEPARTMENT <br /> BUILDING PERMST INFORMATION i <br /> ADDRESS�� G� •- �,� ^ ��/� f ll . TYPE S � <br /> , �: � . � <br /> 1) BUILDING PERMI'f FEE _r- ( <br /> (A) PLA21 CHECK FEE � b� ��G• ��J $ /�c � i <br /> 2) WATER SERVICE TO BE PAID BEFORE BUILDING ! <br /> PERMIT IS ISSUED $ ��� � � <br /> (A) TO BE DETERMINED BY PLHG. INSP. 3/ INCIi P�-�-�j Z�f. D O <br /> (B) EXIST.��/ WATER SERVICE, APPL, N0. ��'�� ��� <br /> (C) APPROX. LOCATION �D � /I/, O7" /�/ Gdy-i� <br /> �� �i�'� ��..�.d ��u,,�, �„� � zS E �cxAa� `o. ' �_ , <br /> 3) DRIVEh'AY PERMIT TO B �AID BEFORE BUILDING �, �`./ <br /> PER+IIT IS ISSUED Z� FT. � . D/W (TYPE) $ �L�l, �n ; <br /> n . <br /> TOTAL* $ � <br /> 9) S�nTUS OF �$EWER CHARGES• <br /> i������ DISTRICT�_ FOOTAGE - � <br /> � N, S, E, W. � <br /> NOTES SEWER CONNECTION CHARGES: <br /> 3 -� 2.0 -I9S'- 00 YEAR � TRUNK $ ��-�. �/ � <br /> i <br /> , <br /> `/� /Tr.ATF/,�RjA�L s -- p — ` <br /> • TOTA�CONNECT�ON'C�ipRGE t <br /> � <br /> s I9�m � <br /> i <br /> SEWER PERMIT FEE $ � Q� � <br /> J CATCH BASIN PERMIT FEE $ <br /> � TOTAL SEWER PERh1IT FEES $ �C/•� ! <br /> S) :J:';:?�1 SEWER CHARGES: —_ � <br /> SEWER CONSTRUCTION: ; <br /> TRUNR $ �.��' ;j <br /> LATERAL $ --�"'"- � <br /> SEWER SERVICE: $ 2, f � <br /> ' AP 80�. ;,p^y]TION OF S DE SE R qR TEE IN THE MAiN: cj . 5 , � <br /> � <br /> � �Jt i"�/. O�iTI� s�Z ,aL� G✓. �c� Or� p <br /> CH11RT <br /> INFO CO. .PZLED BY: � DATE � /2-7� � <br /> F.EVZT'iti: 4 <br /> -- DATE <br /> PRQJECTS DIVISION ! <br /> APP20V:1L: - DATE , <br /> ENGINEERING DEPARTMENT — - � <br /> � <br />