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, � � <br /> e P�i'•Y <br /> t./ � <br /> Sf' <br /> t.' � <br />������ i�� �� <br /> BUILDING PERMIT INFORMATION �� <br /> ' ; <br />' `' I <br /> , �, <br /> • ADDRESS �n�� .� � I�� I�. _ <br />�. (1) E3UlLDING PERNIT FEE g � 7 ( � �I <br /> r ` <br /> I (A) PLAN CHECK FEE — ' � <br /> (2) PLUMBING `)� �, <br /> (3) MECHANICAL f n' 1 ' <br /> (4) STATE SURCHARGES I I <br /> (A) BUILDING CODE � �' <br /> (8) ENERGYCODE ��, <br /> , (5) DRIVEWAY PERMIT _ c�_ ' � <br /> ' $ �q� �— <br /> � <br /> (6) WATER SERVICE TO BE PAID PRIGR TO BUILDING PERMIT ISSUANCE $ CCJ I <br />� (A) TO BE DETERMINED BY BLDG. INSPECTOR ��- �� INCH • <br /> ; (B) EXIST. WATER SERVICE APPLICATION NO. <br /> f7) STATUS OF SEWER CHARGES: <br /> ; BOND — DISTRICT FOOTAGE <br /> • N, S, E, W <br /> ORDINANCf= 1171-85 �1� <br /> WATER l rI'-"1 � <br /> SEWER LI �C'�� <br /> TOTAL ORLI FEE Cn�"Y1� <br /> I SEWER CONNECTION CHARGES <br /> YEAR TRUNK $ <br /> � LATERAL I <br /> i TOTAL CONNECTION CHARGES $ <br /> � I <br /> SEWER PERMIT FEE $ �� <br /> I <br /> i <br /> � <br /> �I <br /> i �I <br /> ' . !. <br />