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TiV;,•),Ili;la(li:G %li;l) (;C):CiVill'1"i S�:1SVla:;:�i <br />llUILD111C Pl:i:rrc�r rn�c)l;nn•rr��rl <br />TYPIi <br />1:UILDI!.G PEII:1IT PFU S 54ti 1 —Z-•&, OU <br />!A) PLAZI CPECK FEE <br />PLUMBING <br />MECHANICAL <br />BITER SERVICE TO BE PAID BEFORE BUILDING <br />P;>W''IIT IS ISSUED <br />(A) TO BE DETE NINED BY PLBG. I!•TSP. <br />(RI EXIST. Y7ATER SERVICE, APPL. 110. <br />INCH <br />$ (sCPl,oS�pUe) <br />S. <br />S <br />(C) APPROX.��',L��OCATION (0G <br />C,' = 4TF� 1;1T 121LU CTTART S —44 <br />MIVM-7 %Y PMtilT TO DE PAID DIFFORE P,UILDING <br />PE N41T IS ISSUED FT. D/W (TYPE) $ <br />} STATUS OF SEWER CHARGES: TOTAL $_ <br />IID\'D DISTRICT FOOTAGE lU6}irAUJ"-- <br />N, S, L•', V1. <br />ITO.iT11LY SEUPR CIIAP.GES: <br />SEWER CONSTRUC2I014: <br />SEVER SERVICE <br />SEWER CO'1*1ECTION CHMIGES <br />YEAR % TRUNK $ <br />LATERAL $ / <br />TOTAL CONPIECTION CHARGE $ <br />/V O,or <br />S),t'ER PFRIUT FEE <br />CATC11 DASIN PS:P:IIT FEE $_ O10 _ <br />TOTAL SMIER PERMIT FEES$ O G) <br />-LATERAL $ <br />AI'PRON. LOCATION Or SIDE SE`it'2 OR -TEE IN TIIE' MAIN: — -�^- <br />C11A11'r c. ✓1��— �G —�J <br />:.IIFO CONP7,14) By: <br />r, <br />APPROVAL: <br />bivvn <br />DATP . <br />1. <br />