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. � <br />DEPARTMENT OF COMMUNiTY UEVEL(>PMENT SERVICES <br />�U(l.DING P��A�il`6' �NFOkMATSQN <br />ADDP.�SS �2C�� %Tia �, UJ, TYPE <br />(1) BUILDING PERMIT FEE ��O�d �� <br />(A) PLAN CHECK FEE <br />(2) PLUMBINC <br />(3) MECHANICAL <br />(41 WATER SERVICE TO BE PAID �'RIOR TO 6UILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINEG Bl' BLDG ItJSPECTOR INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPP.OX. LOCATION SLZ �-- �__ L�IT� L lT`-r' _ <br />S� � �? . <br />--- —� <br />$ 'o?=� 6 <br />aa — <br />_ �. <br />� <br />/o <br />„ �' <br />��--�=�• CHART_ <br />(S) DRIVEINAY PERMIT TO 13E PAID PRIOP. TO �UILDING PERMIT IS- � <br />SUANCE FEET (�-��-�-.<_�- DRIV[�M1'AY(TYPE) � �� <br />� 3 �v= <br />;7) STATUS OF S�R CHARGES: <br />[30ND �.O'�TRICT <br />NO � ES <br />FOOT.�.�� E <br />N, S, E, W <br />SEW��� CONNECTION CHARGE� �� <br />YEAR ��� _TRUNK S � ?o <br />LATERAL �— <br />TOTAL CONKECTION CHARGES � � %'� <br />SEWER PERMIT FEE �`�3�� $ 3 � c <br />CATCH BASIN PERMIT FEE <br />TOTP,L SEWER PERMIT FEES ��G/g�_ -3o J_ <br />(7) MONTh+LY SEWER CHARGES: <br />SEWER C(�NSTRUCTION <br />I�: <br />SEWER SERVICE <br />1 ON (�F�IL�yF S�F)NEg�R TE�FN �HE <br />TRUCK <br />LATERAL <br />� <br />3 <br />.3 F7' <br />U-� ; I �- CHART �-12-Z�C-'4 - <br />INFO COMPILED BY: <br />APPROVAL: <br />9 L'9 <br />DATE <br />DATE <br />, <br />