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BIJILD' NC PERMIT INFORMATION <br /> � <br /> AD'JRESS g��' 2d TN �D�• S' � • TYPE �•�� <br /> (1) BUILDING PERMIT FEE �D,EO�- `Q� S �g� �O�� <br /> (A) PLAN CHECK FEE ��. �U <br /> (2) PLUMBINC 2f _ � p <br /> (3) MECHANICAL �� �� <br /> (4) WATER S:RVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSU NCH <br /> (A) TO BE DETERMINED BY BLDG iNSPECTOR <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> -- -rJ G� .4yDQO.� <br /> (C) APPROX. LOCATION � � <br /> rj- `�6�cs.EGO.e, CHART S- zZB-A <br /> (5) DR!`�EWAY F`ERMIT TQ 8E PAID PRIOR TO BUILDING PERMIT IS- CZ �� <br /> SUANCE Zt FEET �''Ti-' G DRIVEWAY(TYPE) f <br /> s �`j� �5`�D <br /> (7) STnTUS OF SEWER CHARGES: -� ��,, <br /> BOND � DISTRICT �—FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> �-r A�, ���-�`� �s&Q4� <br /> �-b Z <br /> p.� 7�-Z--Bo <br /> �.F, 33`�'°� <br /> SEWER CONNECTION CHARGES 27�-�0 <br /> "�' YEAR � � TRUNK S _ <br /> LATERAL �..7�. �� <br /> TOTAL CONNECTION CHARGES � <br /> SEWER PERMIT FEE 3 <br /> qd� s v��OO <br /> ���I$I � <br /> CATCH BASIN PERMIT FEE Q Qv <br /> TOTAL SEWER PERMIT FEES s <br /> (7) MONTHLY SEWER CHARGES: s � / S -- <br /> SEWER CONSTRUCTlON TRUCK - <br /> LATERAL Se�O <br /> SEWER SERVICE � o� ��p�A" <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: .���T �F��� <br /> �Y � o F � E � .d�oo�K — <br /> CHART u 8 28 5 <br /> DAT E <br /> INFO COMPILED BY: DATE <br /> APPROVAL: <br /> � <br /> 41�79 <br />