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DE►A�TMENT OF �OMMUNITY DEVElO►MENT SERVICES <br />BUILDING PERMIT INFORMATION <br />�f ' _ > •, <br />ADDRE55 � �� I�� L'l - � TYPE,,.� � �- � �- <br />(1) BUILDING �'ERMIT FEE �(,� ua0 s ��-�� <br />(/1) PLAN CHECK i'EE l'T � /L � <br />(2) PLUMBING �o �� <br />(3) MECHANICAL ^�� � <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE � 0 ' <br />(A) TO BE DETERMINED BY BLDG INSPECTOR INCH <br />(B) EXIST. WATER SFRVICE, APPLICATION NO. <br />(C) APPROX. LOCATION <br />'�HART <br />(5) DRIVEWnY PERMIT TO BE PAID PRIOR TO BUILDINC PERMIT IS- <br />SUANCE FEET DRIVEWAY(TYPE) S �� S <br />1 <br />(7) STATUS OF S�R CHARCES: <br />BOND _�_DISTRICT <br />NOTES <br />L�-�� ��� � F 3 <br />��� <br />FGOTAGE <br />N, 5, E, W <br />SEWER CONNECTION CHARGES <br />YEAR TRUNK <br />L�TERAL <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CH11RGE5: <br />SEWER CONSTRUCTION <br />TRUCK <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br />INFO COh1PILED BY: <br />APPROVAL: <br />5-84 <br />s 3�0� <br />''� <br />s -3° <br />s 30 — <br />S <br />CHART �- / 3 —'28- y <br />DATE <br />DATE <br />