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��.. . <br /> �< <br /> . .; ,,fi, <br /> _ � � � <br /> . <br /> �UILDING PERMIT INFORMATION <br /> � <br /> ADDRESS � ��__ <br /> (1) BUILDING PERMIT FEE <br /> y n H (A) PLAN CHECK FEE SS PD <br /> ��� <br /> (2) PLUMBING gn� <br /> �y <br /> G H (3) MECHANICAL <br /> 9HCn <br /> (4) STATE SURCHARGES y S� <br /> K �n (A) BUILDING CODE <br /> H� — <br /> O� H„O� (B) ENERGYCODE 2���r�/ <br /> y y~ (5) DRIVEWAY PERMIT —�„ � 71_��_ <br /> x �� $ _ _�� <br /> t=� <br /> � �� <br /> ` �5� � <br /> �" n (6) WATER SERVICETO BE PAID P^nivR TO BUILDING PERMIT ISSUANCE '"a ---�CZ <br /> a y� (A) TO BE DETERMINED BY B�DG. INSPECTOR___.— __ INCH — <br /> � <br /> t y y (B) EXIST. _WATER SERVICE. APPLICATION N ._ <br /> gd vi (7) STATUS OF SEWER CHARGES: <br /> � ��" BOND DISTRICT__— _ �OOTAGE N, S, � U� <br /> H O[yA <br /> ORDINANCE 1171-85 /� <br /> WATER ---=--Q���/���/_ <br /> SEVJER --- � � � <br /> TOTP,L(�RD. �EE _.----= -- <br /> �� <br /> �� <br /> SEWER CONNECTION CHARGES <br /> ��� _____ TRUNK S —_—_. <br /> YCAR -----_ .. <br /> �! -- <br /> LATERAL <br /> f�. .., TOT:;_CONNECTIOfJ CHARGES S __ _ <br /> ' !����y� <br /> SEWER PERMIT FEE � ---���`�'�"'2`r <br /> r 0 1 <br /> ��,�� �- � 7�D °� �AI/� ��ls`�Gt <br /> �-1 1 w�rc.� - I�% o v <br /> SCwevc - ,� ? I �o <br /> � t��arcr�z se.a� - f�o °� <br /> �.�� � 30 <br /> so <br /> � �yo ,� � <br /> QGrzw� rr � � '� �(�� <br /> ,1 <br /> 1 <br /> � <br />