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. . ��....��..�,,.�.., <br /> -� <br /> . <br /> •, DEPARTMENT OF COMMUN:TY DfVIcLOPMENT SERVICES <br /> � UILL� ING PER11��?� � IV �ORMATIO�! <br /> _��i i Z_ /_� � P, c, � ,'� l5 j r� �--�7�. TYPE G Cr'iti->li�i r - <br /> ADDRESS = <br /> (1) BUILDING PERMIT FEE %/O� vot� ' `�x' S 4�' '�'�� <br /> (A) PLAN CHECK FEE � �� ��� n`�� ` <br /> (2) PLUMBINC ��`'. L�ri - <br /> (3) MECHANICAL - '�° '3 �d� <br /> (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE 3 ��'''�� <br /> (A) TO BE GETERMINED BY BLDG INSPECTOR _ � INCH _; i �- u� <br /> (B) EXIST. WATER SERVICE, APPLICATION NO. <br /> (C) .APPROX. LOCATI�N � " ti*��� � �-� �p�''�-�"- � � �= �� <br /> �v �_��-- .�...,�c� 8 `M�; � /�-GPe��x � �'cv t-i <br /> �J b4= � CF (� l�l-S'r !�._ I �_ z_�i � �._ <br /> t�HART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO 6UILDING PERMIT IS- <br /> SUANCE FEET DRIVEWAY(TYPE) 5 — <br /> g <br /> (7) STATlJS OF SEWER CHARGES: <br /> BOND DISTRICT fOOTAGE /=-��'%�l�i�✓ C�`��'� /" <br /> N, S, E, W <br /> NQTES <br /> �[-7L� I_����Q�'f%''�rc=z,`/ I=EL�-� <br /> F'��'-t� Lv (�, �--f� �' i <br /> LS�L=�J --�- <br /> � <br /> �f- c:i.�:� ; .�'r- "1'��i 1 . c, u <br /> SEWER CONNECTION CHARGES i <br /> YEAR TRUNK $ <br /> LATERAL <br /> TOTAL CUNNECTION CHARGE� $ <br /> 3O. ��� ��� <br /> SEWER PERMIT FEE $ <br /> �� � �, �) � <br /> CATCH BASIN PERMIT FEE — <br /> TOTAL SEWER PERMIT FEES $ !��-' � ���C� <br /> (7) MONTHLY SEINEIt CHARGES: , <br /> SEWER CONSTRUCTION TRUCK 'S <br /> LATERAL � <br /> �/�c�T�=�[_.n � <br /> SEWER SERVICE � <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: � ������ � �� '��'"�� �, <br /> Tiz`s < <J !-rr��� ,J_.., ,anv¢-�•� i Z 1--� � 3 L rT S ��= M�r <br /> � <br /> 'I-z F� u�Z�, CHART :� -1�-ZR','- <br /> frvi-�^._.!J x � 'Tb `7 — <br /> INfO COMPILED BY: DATE <br /> APPROVAL: -_ _ DATE <br /> 9-1 79 <br /> _�` _ . — _ _ " ! � ' <br />