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DEIAtTMENT Oi COMMUNITY DEVELO�MENT SERVICES <br /> [3UILDING PERMIT INFORMATiON <br /> ADDRESS � 7• � ��yi-� P- . S.G TYPE ✓Otil��i �= <br /> (1) BUILDING PERMIT FEE� 2���� S Cr��33.E)v <br /> IA) PLAN CNlCK FEE /'U`� 7 yv4� � _ <br /> (2) �LUMBI'JG �� •OU <br /> (3) MECH/,NIGL y�� �� <br /> (4) W�1TER SERVICE TO BE PAID PRIOR TO EUILDING PERMIT 15SUANCE �pD. OC7 <br /> (A) TO BE DETERMINFD BY IiLD(; INSPfCTOR � INCH <br /> (B) EXIST. W�TER SERVICE, 4PPLIC.�TION NO. <br /> (C) APPROX. LOCATION �(d,Q�@i►70.S��' •X <br /> '�PT �.l 8� .} ��c� ,Z ,, � i <br /> ._ /-. I� , CHART � ` � - <br /> f5) DRIVEWAY PERMIT TO BE PAID PRIOk TO BUILOING PERMIT IS- <br /> � SUANCE ____ FEET _ DRIVEWAY(lYPE) S �5 ' �- <br /> S <br /> (7) STATUS OF SEWER CHARCES: <br /> BOND "77I DISTRICT FOOTAGE <br /> N, � E, W <br /> � NOTES <br /> ��t�c+�i2 P� /'�_� <br /> �o // 7/- f3`�" <br /> �s9��co x • iz�8 = <br /> E/�.o- /90, 34- <br /> S��a2- sa. Sz <br /> __-----• <br /> � ��,C�L, /(p 5[WER CONNECTION CHARGES ��� (� <br /> YEAR �� _TRUNK S <br /> LATERhL — � <br /> TOTAL CONNECTION CHARGF.S S = `��� �a - <br /> SEWER PERMIT FE� s ��'�`��-- <br /> CATCH PASIN PCRMIT FEE — <br /> TOTAL SEWER PERMIT FEES s -�"��'�J <br /> (7) n1�NTHLY S[WER CHARGES: <br /> SEWER CONSTRUCTION TRUCK f <br /> LATER�L <br /> SfWER SERVICE <br /> APPROX l.t)C�TION OF SIDE SEN�ER OR TEE IN THE MAIN: �T' T � �.s� �OPC..h <br /> =�� �-•r CU �� __h1_.1 I n�-pni uor t,� r� A-rt..r� o�, _ <br /> �:,ti�-d„¢1-- CHART � - /S'�ZB-�� <br /> INFO COMPILED BY: DATE <br /> APPRc�VAI: _ DATE <br />