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DE�AIITMENT OF COMMUNITY DEVEL0��4EKT FEIIVICFS <br />f3UiLDiNG PERMIi INFORMATION <br />ADDRE55 ��C`��> � CJ(vz-�.� I��_ S.'�---TYP[ S. F- 2 <br />(1) BUIL[�ING Pf.RM1T FiE Q-?�,c9P�0'�d S LSI.SZ7_ <br />(A) PLAN CHECK Ff.F. Z9.2S Dt.IC <br />(2) PLUMBING Z�- n0_ <br />(3) MFCHANICAL Z�L •SD <br />(4) WATER SEF.VICE TO BF PAID PRIOK TU RUIIDRJ:; PERMIT ISSUANCE� 54� O• D� _ <br />(A) TO 8E DETERMINf D BY BI.DG INSP[CTOR . 3�.�_ IN(:H <br />(B) EXIST WATER SERVICE, �PPLICATION NU. <br />(C) APPROX. LOCATION _ <br />CHART ___ _ <br />(5) DRIVF.WAY PERMIT TO fS[ PAID PRIOR TO BUILDING PfRMIT IS-�Fqrf <br />SUANCf. ____—__FEFT _ __.__DRIVEWAY(TYPE) S 2�'0� <br />. <br />�� E — <br />(7) STATUS OF SEW[R .r.HARGfS <br />HO�:[� _._� ( I_ �ISTRICT <br />NOTES <br />�,{J�Q. 'fJ �l , �-E <br />c�r� 48d-� <br />S •� = 2�,s. <br />� �;ip. � <br />FOOTAGF <br />N. 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR � S _ TRUNK <br />LATERAL <br />TOTAL CONNECTION CHP,RGfS <br />SEWfR PERMIT FEE <br />CATCH BASIN PERMIT FFE 3SI�� <br />TOTAL SEWER PERMIT FEES <br />('/) MnN f Hl Y SEW CR CHARGES <br />SEWER CONSTRUCTION <br />5 3�0_ OU <br />—, <br />t, 3�� _r9c: <br />� 30.00 <br />----• <br />s �•ed <br />TRUCK S <br />LATER�.L <br />5[WER SERVICE <br />APPROX LOCATION OF SIDE SE WER OR TEE IN THE MAIN: <br />INFO COMPILED BY <br />APPROVAI_ ____ <br />s ea <br />CHART <br />DATE <br />DATF <br />