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.� � �- • �._ � _l <br />DEPARTMENT OF COMMUNITY pEVELOPMENT SERVICES <br />!BUILf,ING PERMIT INF06tN1AT10N, <br />ADDRESS —TYPE ���/�*� NI�L� �•5 <br />(1) BUlLDING PERMIT FEE %(a�ODD• � 5 •�Dv <br />(A) PLAN CHECK FEE /�' � �'t�UE <br />f21 PLUMBlNG 20.c`�O <br />(3) MECHAM�AL i �, �'U <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILUING PERMIT ISSUANCE ��'�� <br />(A) TO BE DETEliMINED BY BLDG INSPECTOR � INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPr20X. LOCATION .__ <br />e <br />J <br />CHART <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS- <br />SUANCE FEET DRlVEWAY(TYPE) g ZO,O� <br />$ <br />(7) STATJS OF SEWER CHP,RGES: <br />BOND -��— DISTRICT <br />NOTES <br />� �?�� �Z� �- <br />�.� //7/ —g,� <br />.�',. C. 2. <br />��� `t'= <br />�l2 0 �7q. � � <br />>�� 4= �� � <br />=� r�50. � <br />FOUTAGE <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR � � TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWEP. PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CQNSTRUCTION <br />S �3�, �7 U <br />$ ?3�, C9D _ <br />g 3�• �O <br />TRUCK $ <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF 51DE SEWER OR TEE IN THE MAiN: <br />INFOCO�`1PILEDB�: _�._ <br />APPROVAL: ._.._ <br />;;. •�..,.. <br />.,, <br />5•84 <br />CHART <br />DATE <br />DATE <br />� ��. S <br />2 -��-8 h <br />