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DEPARTINENT OF COMMUNITY DEVELOPMENT SERVICES <br /> I3UILDING PERMI�' INFORMA,TION <br /> ADURESS &Q �� ��T�+ �2. S•�� TYPE S ���c,� �AM .Gt� <br /> (1) BUILDING PER�tIT FEE �Y Zo,Ooo •� g ��3- OD <br /> (A) PLAN CHECK FEE P�:� ZQOLd <br /> (2) PLUMBING � ��o <br /> (3) MECHANICAL Z� � <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUIL�71h'G PEyR�M�IT ISSUANCE _ �� ' v� <br /> (Aj TO DE DETERMINED BY f3LDG INSPECTOft_-1� INCH <br /> fCj EX15T. WATER SERVICE, APPLICATION NO. <br /> (C) APPROX. LOCATION <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TG BUILDIN; PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) S —�� '� � <br /> $ (y�'j .C90 <br /> (7) STATUS OF SEWER CHARCES: <br /> BOND 1= DISTRICT FOOTAGE <br /> N, 5, E, W <br /> NOTES <br /> SC�1oc� St��.�s <br /> prLr� I,iz� —85� <br /> �},, � -�:.z�, �� <br /> s�.u�- s�r <br /> � l .� ,� <br /> SE�NER CONNECTION CHARGES <br /> YEAR �� TRUNK $ �30 `�D <br /> �_-- <br /> LATERAL <br /> TOTAL CONNECTION CHARGES $ ��� ��� <br /> SEWER PERMfT FEE $ �� � �� <br /> �- <br /> CATCH BASIN PERMIT FEE �Q-O� <br /> TOTAL SEWER PERMIT FEES $ <br /> (7) MONTHLY SEWER CH/tRGES: <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCnTION OF SIDE SEWER OR TEE IN TFIE MAIN: <br /> CHART <br /> INFO COMPILED BY: DATE <br /> APPROVAL: DATE _ <br />� s�aa <br /> I �� . <br />