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� <br />r <br />r <br />L <br />L <br />r <br />� <br />{: .� <br />DEP�IRTMEkT OF COMMUNITY DEVELOPMENT SERVICES <br />BUILDII�dG PERMIT INFORMATION <br />ADURESS �� �V ��t'C f�- l`�- TYPE S� � <br />('i) BUILDING PERMIT FEE y7 poo % S -��o e-� <br />(A) PLAN CHECK FEE — <br />(2) PLUMBING � y �T <br />(3) MECHANICAL /-s � <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE _ ti � � <br />(A) TO BE DETERMINED BY BLDG INSPECTOR �1� INCH <br />(B) EXIST. WATER SERVICE, APPLICATION IJO. <br />(C) APPROX. LOCATION <br />CHART <br />(5) DRIVEWAY PERMIT TO BE PAID /F'RIOR TO 4UILDING PERMIT IS- <br />$UANCE - �� FEET L�DKIVEWAY(TYPE) $ �� sy <br />g .3 7/ - <br />(7) STATUS OF SEWER CHARGES: <br />BOND ��DISTRICT <br />NOTES <br />FOOTAGE <br />N, S, E, W <br />SEVVER CONNECTION CHARGES � <br />YEAR 8'�- fRUNK S a�� <br />LATERAL � <br />TOTAL CONNECTION CHARGES $ �� �� <br />�` <br />SEWER PERMIT FEE $ 3 O <br />CATCH BASIN PERMIT FEE � <br />TOTAL SE�JER PERMIT FEES S 30 �_ <br />(7) MONTHLY SEWER CHARGE:.: <br />SEWER CONSTRUCTION <br />TRUCK S <br />LA (EP.AL <br />SEWER SERVICE <br />APPR.OX. L��CATION OF SIDE StWER OR TEE IN THE MAIN: <br />INFO �OMFiLED 8Y: <br />APPROVAL: <br />�}749 <br />CHART L la � �Y S� <br />DAT[ <br />DATE <br />� <br />■' <br />� <br />� <br />