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DEPARTMENT OF COMMUNITY DfVELOPMaN'i i'[RV CES <br />B�ILDIN� PER�9T �NF'O�MATION <br />ADDRESS Z{' %T�`}-�e.GC� -- —T'iPE__ � F"�� <br />c��.� �O • �� $ � ��p� �v <br />(�) BUILDING PERMIT FEE <br />(A) PLAN CHECI: FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUII.DING PFRMIT ISSUANCE <br />(A) TO BE DETERMINED BY EiLDG INSPECTOR 3��_ INCH <br />((3) EXIST. _.—. W�TFR SERVICE, APPLICATION NO. <br />(C) APPROX. LC�CATION <br />2�¢��� <br />/5 -C9 U <br />CQG'-DU <br />CHART L— � Z- Z-5' -� <br />(5) DR'VEWAY PFRie11T TO BE PAID PRIOR TO [3UILDING PERMIT IS- Zp_ �� <br />/oGj <br />SUANCF. FEET _DRIVEWAY(TYPE) S <br />S _ <br />(7) STATUS OF SE��ER CHARGI_5: <br />BOND -�� .—DISTRICT <br />N(:)TES <br />FOOTAGE <br />N, S, E, W <br />SEW[R CONN[CTION CHARGES <br />YEAR c�S� TRUNK <br />LATERAL tceca s %�yol-9 <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE �c/4y3 <br />TOTAL SEWER PERMIT FEES <br />p) MONTHLY SEWER CHARGES: <br />SEi'VER CONSTRUCTION <br />g �: %� - � u <br />$ 2 ��� . �,; <br />g 3O-C�O _ <br />TRUCK $ <br />LATERAL <br />SEINER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: _— <br />g.l 7Y <br />CHART _L '� l ' Z� —� <br />DATE <br />DATE <br />�� . <br />,_ . . <br />U;. <br />� .. <br />�` <br />��: <br />�,'i <br />�i <br />r� : : <br />c <br />�:: <br />�, . <br />�". <br />� : <br />y : <br />r <br />� <br />c <br />A' <br />�� <br />