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UEMRTMEN7 Oi CU:�T�MUNITY QEYELO�MF.N7 SERVICES <br />�lJl[.UI�VG PERMIT �N���.�r�;AT��I� <br />nonREss _ �� � 5� 7 `� �=i" ic' TYPE �S'- �:�'. <br />�---- <br />('I) BI,�LDING PERMIT �EE 3 _ „�,<,-t �' <br />(A) nLAN CHECK FEE �---�— <br />(2j PLUMBINC �r- a-'� <br />(3) MECHANICAL �.. /6?�_ <br />(4) WA1�FR SERVICE TO BE PAID PRIOR i0 BUILDINC; PER,;L�IT ISSUANCE _bc� �– <br />�A) 1�iJ BE DETERMINED BY BLDG INSPFCTpR ?� _;NCH <br />(�) EXIST. WATER RVICE�A-KPLI ATI <br />(C) APPROX. LOCATION�c � � ,.!- ' <br />_�� <br />_� -C-N� CHART <br />(5) DRIVFWAY PERMIT TO BE PAID PRIGR TO BU� DING PERMIT IS- <br />iUANCE � FEET � <br />� ` RIVEWAY(TYPE) 3 �oc ,�� <br />$ �L��'J � <br />i%1 S�ATl15 OF SE�CER CHARGES: <br />BOND � DISTRICT <br />NOTES <br />FOOTAGE <br />N, S, E, W <br />SEWER CONNFCTION CH/�RCES <br />YEAR �%Z __ TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />l'7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />SEWER SERVICE <br />,� <br />i <br />S �70� <br />o� <br />s 30 � <br />S �i O -�-- <br />TRUCK 3 <br />LATERAL <br />'.PPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED 8Y: <br />APPFOVAL: <br />� �v <br />CHART <br />DATE <br />DATE <br />f <br />