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DEM�iMtNT Of �OMMUNITY DEVELO�MENT SERVICEf <br />BUILDIN�G PERMIT INFORMATION <br />ADDRESS � .2 G �S� rI �Lf • ..fl. ., . TYPE �� � ��• <br />(1) BUILDING PERMIT FEE �/,poo � S � y� �" <br />(A) PLAN CHECK FEE _ ��w <br />(2) PLIIMBING _..�o �� <br />('il MECHANIC�L �2 �— <br />(4} WATFR SFRVICE TO flF PAID PRIOR TO RUII.DING Pf.RMIT ISSUANCE �0 � <br />(�) TO BE DETERMINED BY BLDG INSPECTOR �y INCH <br />(B) EXIST. �/T WATER SERVICE, APPLICATION NO. <br />(C) �PPROX. LOCATION <br />CHART <br />(5) DRIVEWAY PFRMIT TO BE PAID PRIOR TO RUILDING PERMIT IS- <br />SUANCE FEET DRIVEWAY(TYPEj S D� <br />3 <br />(7) STATUS OF S_�ER CH1IRGES: <br />ROND �� DISTRICT FOOTAGE <br />NOTES <br />N, S, E, W <br />SEWER CONNECTION CHARCES <br />YEAR TRUNK <br />LATERAL <br />TOTAL CONNFCTION CHARCES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER C4NSTRUCTION <br />SEWER SERVICE <br />`[ZIL� <br />LATERAL <br />^PPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COMPILED BY: <br />APPROVAL: <br />5•94 <br />s 33Q �� <br />S � � ` r— <br />S 30 " <br />S <br />CHART �� _ /3 '.� b � <br />DATE <br />D�TE <br />