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TiUILDING PrRMIT 7NrORMATION
<br /> . ,,,
<br /> f1DDRrSS � ,f �
<br /> TYPEOI BUILDING .,'' r, ------- --• DAT� ,'_.,�..� ,;'
<br /> 1) L'Li11.nING PI:RMIT F�L': �' ���y ��
<br /> (A) PLAN CII�Cl< '1=r �' Gsf, �"'Z�
<br /> 2) `.'"i�1'I:R S1:RV7CI: 7'O 1SL 1'/'.I]) I31:1�ORE BiIILll;NG � f• �+�
<br /> PERnil'1' IS 155UFD
<br /> . r,�.' ,
<br /> ;':.) 'i'O P,Is ]�I:'TLR�fII�:'.•.'D ]3Y PLI3G. INSP. - :- INCH
<br /> !�? F:XIST. �4'AT�R SERVICE, APPL. NO. _
<br /> ,1• < ; t `� ''� ,-,�� r. ";�" .
<br /> {C) LOCATION - • • "' '
<br /> ��'�.Spi±�1�'" ?T^ ,r4� , .�a; �' 1:''j4�.!"r '�+r`' "�, CHART :�p>F ��. :.:� ''
<br /> 3) DP.IV��VAY PEi2hI1T TO I3E PA1D IIl"] ORE BUILllING _.,d,�..�..f;
<br /> PF.RAIIT IS ISFi�J�D ,'J;!" FT. ...n,�..u•,:-. D/�V (TYPE) �v .-�.^-r�%�'
<br /> . . � R/c:'.i�-:1�:�. .,f� . � 'i! _:.f"!'.:� U` �
<br /> " � TOTAL�� $ � ��•
<br /> �LF� L, �U` C7
<br /> 4) S7ATUS OF SE\1'ER C1-L�RGES: � .
<br /> - "- ' '- FOOTAGE �-��
<br /> EOND ;?:". DISTRICT ,..� . _.._._ ___- __.
<br /> N, S, E, �I'. ,1 � / . d L)
<br /> LA\DSC:�PE NOTP:'S SE\1'�R CONNECTIC\T CfL412GES: �G,r,._,
<br /> TP.U�IK �; �._.c�'<' —
<br /> J_ �� " �9'.- D C� LATERAL 5 `
<br /> ;':�.'""'
<br /> TOTAL CON.iECTION GFi�RGE 'i � ! •-=7• C.�.C✓'
<br /> 5�1:`ER P�RMIT F�E S ���"�'��
<br /> GATCII BASIN FER\SIT FEE $ '-""�
<br /> TOTAL SE�VER PER�•SIT FEES 5 ���'��`'
<br /> 5) \t0\THLY SE�S��R CI-LARGES: •
<br /> SE�VER CONSTRUCTION: r/ �_,- '
<br /> TRUNI{ � --
<br /> LATERAL �v �~ —.
<br /> SE? ER 5ERVIC�: � � �'�'�''
<br /> LOCATIn��7 OF SIDE SE1V�R OR. TEE IN�THE MAIN: CHART �.�' �=S:�y�-.�`�,�-"� ,._.
<br /> �.�. �'.f�..�• f� a • ` '��'� , I" ' .„(
<br /> �; �. �1�'.J', ,;�/ t .�;' �'�`'�'� a�.l , �;.,
<br /> , . e,.s'�t�. �—ae-cv-.r/'�«/'.a�.-,l.� .� E'� y �+�''�• C..: !�F'`:�"�,.`r`�. !. ,",� �.��Q.
<br /> . � � �� �- , , �,��. D.ATr•_ /-� �
<br /> �-
<br /> InFC CO\•1PIL�D F3Y f::��.+n� �� "� '
<br /> �� 7 r / DATE
<br /> R�\'IL•'\V: U,j� " �I,11- ��� 'I� i , '�,l.�,l�., I11(!�, .. ---._
<br /> 2R F IG DIV ISION
<br /> ,/// ! /2
<br /> APPP.UVAI� DA'lE� i.G
<br /> L•'NG1N1:L t1NG llLYAR'1'i�1L•'NT
<br /> >: 7his total musl hc paid hcforc Uuilding permit is i,suod.
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