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r� <br />ENGINEERING DEPARTMENT <br />BUILDING PERMIT INFORMATION <br />P.DDRESS '� �/ {- 7 L��o TYYE <br />�D M w) <br />1) HUILDING PERMIT FEE Cn`�, 000- �a $ ��7 00 <br />(A) PLAN CHECK FEE $ � � ��� <br />2) L�F.TER SERVICE TO BE PAID BEFORE BUILDING <br />PERMIT IS ISSUED $ 2 Q� OU <br />(A) TO BE DETERMINED BY PLBG. INSP. 3� INCH ��'�'�� ��q�GU <br />�B) EXIST. — WATER SERVICE� APPL. N0. — �� `�� <br />(C ) APPROX. LOCATION �M n ;�, �q ' � � �' � o � � TN <br />CHART S-33'L <br />3) DRIVEWAY PERMIT TO BE PAID BEFORE BUILDING <br />PERAIIT IS ISSUED 30 FT. s h D/W (TYPE) <br />TOTAL* <br />4) STATUS OF SEWER CHARGES: <br />BOND�� DISTRICT ��S FOOTAGE d <br />N, S, E, <br />3-3s' ��`�-vl <br />1��6 sewe-r Qua�/�b/E <br />., <br />� 5e�c°r L �,� c 17.��,�,�, %�- �i <br />� :�:� I <br />� ' t� ' <br />�;1.. . �iJ�: �un�' .,L�i <br />�hGRCJ� � <br />l %o � °{ �:{��'`, <br />� �' S.dr reti�, <br />�j�� �'i�:�. �c h�,� 1- a1�. _, � . , , .. . <br />; . i ,- <br />SEWER CONSTRUCTION: <br />SEWER SERVICE: <br />$ /S, o0 <br />$ <br />SEWER CONNECTION CHARGES: <br />YEAR �� TRUNK j $ � �% �%i � �� <br />,," ,.;,,,s,,. ,: , ��,�' <br />:. �.. ,� ., : , LATERA�,� q -$_ <br />TOTAL CONNECTION CHARGE/�G $ ---��--� <br />�lt'y�• _. <br />SEWER PERMIT F�FEy�'� .- $ 3O• �� <br />/D•��-a, <br />CATCH 13:�SIN P�RMIT FEE $ <br />TOTAL SE�9ER P�RMIT FEES $ <br />TRUNK <br />LATER'�L <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />$ 2 �-z �j <br />$ -'Y-� <br />$ /��Ii'�2_.b-�» <br />CHART �j[- X - 18 -28-5 <br />INFO C��DSPILED BY: _� ,,; �_ DATE�- 9-7� <br />REVIEW: <br />PROJECTS DIVISION <br />APPROVAL: <br />ENGZNF.ERING DEPARTMENT <br />DATE <br />DATE <br />* This total must be paid before building permit is issued. <br />r "l,i. <br />��.=�_ <br />i '� <br />