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ENGINEERING AND COMMUNITY SERVICES <br />' <br />BUILDING PEMIT INFORMATION <br />ADDRESS <br />W TYPE <br />%• <br />14W <br />1) BUILDING PERMIT <br />FEE y <br />$ <br />IR 7, 0 U <br />(A) PLAN ' AECK FEE <br />S <br />93. 5 O <br />2) PLUMBING <br />3) 1'ECHANICAL <br />4) NATER SERVICE TO BE PAID BEFORE BUILDING <br />PERMIT IS ISSUED <br />$ o U <br />$ crb <br />$ "Zoo. ov <br />(A) <br />TO BE DETERMINED BY PLBG. <br />INSP. L INCH <br />M <br />EXIST. WATER SERVICE, <br />APPL. NO. <br />(C) <br />C •SQG2�� '7 I pt- <br />ll� 0h^ <br />�AP�PROX,.LOCATION <br />CIIART <br />5) DRIVEWAY PEMIT TO BE PAID BEFORE <br />BUILDING <br />PERMIT <br />IS ISSUED 1,0 FT. <br />D/i9 (TYPE) <br />2, <br />6) STATUS <br />OF SEWER CHARGES: <br />TOTAL <br />$ o <br />BOND <br />f <br />DISTRICT /Z �, <br />FOOTAGE <br />— <br />N, S, E, W. <br />NOTES <br />/) MONTHLY SEWER CHARGES: <br />SEVER C014STRUCTION: <br />SEWER SERVICE <br />SEWER CONNECTION CHARGES <br />YEAR <br />% 7 1'1tUYf: $ <br />d <br />2�0' <br />LATERAL <br />$ <br />-- <br />TO <br />SEER <br />CONNECTION CHARGE$ <br />PERMIT FEE <br />S <br />/D' �O <br />ao..0P <br />il 1� / 0 c <br />CATCH <br />BASIN PERMIT <br />FEE $ <br />TOTAL <br />SETTER PERMIT <br />PEES$' <br />Oa <br />S TRUNK $ <br />LATERAL $ <br />$ 2• <br />APPROX. LOCATION OF SIDE SP•.WER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />CHART F-p,- 3-78-4 — <br />DATE <br />DA'1.'E <br />