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� y-/ `1 � <br /> DEYARTMENT OF COMNiUNI�TY DF.VELOPMENT SERV�CES <br /> � UdLDING PERIVIVT INFORMATION <br /> ADDRESS /C'�� /�¢�`'' �`'. J.c' , TYPE �'�2 <br /> (1) BUILDING PERMIT FEE �C�9�3�0- �'J g '��- Oo <br /> (A) PLAN CHECK FEE <br /> (2) PLUMBINC ��� �� <br /> (3) MECHANICAL 27- c� U <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE CoE -O� <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR ��� ING'. <br /> (B) EXIST. �'JATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATlON �� � � �� p�'�"�'' 3 FT <br /> l.l oc s.c com oa L-c�� CHART 5- 3�8 <br /> (5) DRIVEWAY PERIv11T TO BE PAID PRIOR TO BUILDING PERMIT IS- // �a <br /> ;iUANCE 22 FEET �5����SU7 DRIVEWAY(TYPF.) S <br /> $ �./ (0 7_ u Cl <br /> (7) STATUS OF SEWER CHARGES: <br /> BOND �� DISTRICT �� FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> .-/�at� l�ctJ�ZoP�ulEu�� Ci�1�ei�LS <br /> �,e/� 7/�-�� <br /> I�(Z� Z <br /> s. F= �_�. �v3`�. a-c� <br /> �/�- /�( <br /> SEWER CONNECTION CHARGES <br /> , YEAR � � TRUNK S ���' � v <br /> LATERAL <br /> TOTAL CONNECTION CHARGES $ '� ��� � <br /> 6� <br /> �f.�d $ �p. GC7 <br /> SEWER PERMIT FEE ( <br /> CATCH BASIN PERMIT FEE G/��Ig �— <br /> TOTAL SFWER PERMIT FEES $ ��` �� <br /> (7) MONTHLY SEWER CHARCES: <br /> SEWER CONSTRUCTION TRI�CK $ 2 � S/ <br /> LATERAL <br /> s, / D <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAlN: 57u��� �� p�� �P��� <br /> fZ �-[_ I�l UF `� -�. GoG t� c Lo���PPZC9t� � rz O� � <br /> CHART_�- �y- Z�- y <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE <br /> 9-1-79 <br /> li <br /> H <br /> IL ,. <br />