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BUILDIP�� �'�R�'v1�"�' IN�ORMATION � <br />ADDRESS L O`�� C`.�� � Tct T.�(.'- S•C • TYPE ���tt-��-�- f�13i�7i UY �.LF� <br />(1) BUILDING PERMIT FEE �-70,UlJl� • U $ ��j0��"•��� <br />(A) PLAN CHECK fEE —��=�� <br />(2) PLUMBING ��� � � <br />(3) MECHANICAL �'�" ��� <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE � �' �� _.— <br />(A) TO 8E DETERMINED BY BLDG INSPE;:TOR � INCH <br />(R) EXIST. WATER SERVICE, APPLICATION NO. <br />(C) APPROX. LOCATION ��'"�u��'�� � �' �-1 � %����'�='k <br />�� �r !-� �� SE G� � cHnar L - L �( -Z,� -s � <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- /� <br />SUANCE FEET DRIVEVI�AY(TYPE) S L� <br />8 <br />(7) STATUS OF SEWER CHARGES: <br />80ND �� DISTRICT FOOTAGE <br />NOTES <br />�4�I�t. �l-zrc,tr�, <br />O,� l /71-8� <br />1�f-� O I� 9. �'� <br />�--�,,���2 c{--Z ( - � O <br />���pc� <br />N, S, E, �' <br />� <br />SCWER CONNECTION CHARGES <br />YEAR ��' TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />S[WER PERMIT FEE <br />CA76H BASIN PERMlT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER C�iARGES: <br />SEWER CONSTRUCTICy <br />SEWER SERVICE <br />TRUCK <br />LA7ERAL <br />APPROX. LOCATION Of SIDE SEWER OR TEE IN THE MAIN: <br />l.a � Y� � x I� f�-� � trf� �`-� . F� � ��,� <br />� <br />INFO C�JMPILED 8Y <br />APPROVAL: <br />s o�� <br />g �?,� E� <br />3R'S• c�v <br />g �`Z Z S� 6Z7 <br />5 _ �'-C3C) <br />g �.�• �� _ <br />S <br />[i4 T -'� �pf.�P_)ryJ �O �l�-' <br />CHART � - �i�r-7.�-�' <br />DATE <br />DATE <br />