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v� <br /> � <br /> _ -----7 <br /> — _ <br /> � • , <br /> II . DE►ARTMENT OF COMMUNITY DEVELO�MENT SERVICES <br />; BUILDING PlRMIT INFORMATION � <br />''; . <br />� 11DDRESS �-Y¢ 2.11�TH D,e, S.E, T <br /> �YPE �J' -�-�-. <br />� (1� BUILDING PERMIT FEE 52• �aJ��v s �S� OU ', <br /> (A) PLAN CHECK FEE Do.W f�"�; S ' <br />� (2) PLUMBING ��_QC <br /> I �� (3) MECHANICAL /l. C7l ~' <br /> (4) WATER SERVICE TO BE P,41D PRIOR TO BUILDING PERMIT ISSUANCE <br />�� (A) TO BE DETERMINED BY BLUG INSPECTOR 3�4- INCH <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION � u.�a/y 4 c.P�y. Tv <br /> �. �' �Z3J9v cy-3l-S� . <br />� �JyIZ!lG7cl,r�. CNART �- �''' 2$•-� <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS- � <br />� SI.�ANCE FEET DRIVEWAY(TYPE) S _. -�'�� ��g '�y <br />' s �' <br /> (7) STATUS OF SEWER CHARGES: <br /> � <br /> BOND -� DISTRICT FOOTAGE <br />, <br /> N, 5, E, W <br /> NOTES <br />, ' � <br /> �4.t�C� IX�/C�•c�-�c�1T � <br /> I � � i <br />, G�2C� 7ZZ-827 <br />� ' � 2 <br /> I ''- ; <br /> ; <br /> �33�=� �5��� <br />,f <br /> � <br /> SEWER CONNECTION CHARGES <br /> � YEAR g' 3 TRUNK 3 27�` Db <br />, � LATERAL --` <br /> TOTAL CONNECTION CHARGFS S 4��' �a I <br /> . SEWER PERMIT FEE S 30•OD <br /> CATCH BASIN PERMIT FEE —' <br /> TOTAL SEWER PF.RMIT FEES S 3C�-�a <br /> (7) MONTHLY SEWER CHARCES: <br /> SEWER CONSTRUCTION TRUCK f � <br /> LATERAL , <br /> ; SEWER SERVICE . <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: LQ? �>✓e.atp Ti� P/c� � <br /> —��--- � <br /> L{l��.c tSC: .�/. DF S.� GF� OF LOT {� ,01'fil.OE SFi OC3� <br /> - CHART U" �'"L$- � � <br /> J � <br />( INFO COMPILED BY: DATE <br />' APPROVAL: DATE <br /> � <br />� a�-�v � <br />