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OE:�ARTMENT OF CO.'1MUNITY DEVEL�,. MENT SERVICES <br />BIJILDING PERMIT INFORMATION <br />ADDRE55 90/ /O¢ Tiv R. 5�• TYPE �•��� <br />(1) BUILDING PERMIT FEE rliQ, 5�•^• �' S �22' �C <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 BE DETERMINED BY BLDG INSPECTOR.__� INCH <br />(B) EXIST. WATER SERVICE, APPLICATION NO. __ <br />(C) APPROX. LOCATION sTu�tw�cn T� W�-- ��ot+-+. 3i�'r <br />W eR SiE �•� w. L.er CHART 5-'S�� <br />2��00 <br />2 2 � 15 G� <br />!o0•do <br />(5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- <br />SUANCE �7 FEET `���G DRIVEWAY(TYPE) 3 �'S� — <br />5 ¢37 � _ <br />(7) STATUS OF SEWER CHARGES: <br />BONDj�'�� DISTRICT �_FOOTAGE <br />N, S, E, W <br />NOTES <br />6�ioL f� Ci�,o,�-4t= %� G1co 722-..'z' <br />SEWER CONN[CTION CHARGES <br />YEAR Bv TRUNK b .3�%_4 U <br />LATERAL ' <br />TOTAL CONNECTION CHARGES S 3G2 • 5� <br />�� - <br />SEWER PERMIT FEE �� I� 3�"�� <br />CA1CH BASIN PERMIT FEE ��"I 1 <br />I� <br />TOTAL SFWER FERfv11T FEES S •�"�� <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION TRUCK s �'« <br />LATEFt� L <br />SEWER SERVICE — �s—'�� <br />APPROX. LOCATION OF SI�JE SEWER OR TEE IN THE ��IAIN: M/��� l�PPR-ax 3 F-T <br />W l7f- � 6t �iTw T�4. S�� LpT To p�� /�PP2mT � PT W trr�- <br />S.t. ��ti �s LeT _ _ CHART �`l4-Zb-S <br />INFOCOMPILED BY: <br />APPRUVAL: <br />DATE <br />DATE <br />