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BUILDIivG PERMIT INFO�tMATION <br /> ADDRESS ' TYPES��E <br /> (1) l.IUILD�NG PERMIT FEF �'SS�OOO• � b 37. (9 �_ <br /> (�) PL�N CH[CK FEf: �F� ��'C7 <br /> (2) PLUMOING ��'J� C��_ <br /> (3) MECIiANICAL _ �U <br /> (4) W�TCR 5[RVICf TO IiC. P�ID PRIC)R TO flU1l bING PEI�M17 155UANCE _ �QD •��_ <br /> (A) TO 8[ DETI:RMINFD RY IILbG INSPECTOR INCIi <br /> ([1) fiXIST __ \NATC.R SrRVICC, �Pf'LICATION NO __ <br /> (C) APPROX IC�.:ATION __ ____ <br /> C I I�R f ---- — <br /> (5) DRIVEWAI' Pf. RA11T TO f3F PAID PRIOfi TO lIUILDI�IG ;[Rh11T IS /� <br /> SUANCE Ff:�T _ ___ DRIVFWAY(TYPE) b __G�. �� <br /> � <br /> (7) STATUS OP S[N'C.R CHARGES. <br /> I)c�ND �= DISTkICT _ _ f(�OT�Gf: __ <br /> N, 5, F, W � <br /> NOTES <br /> C� lL'll - '8`0� <br />� ��,(.� 114 • v D <br />� S� �1 l . 0 U . <br /> : �� a . <br /> 1�i%• SEWER CONN�EC�-1�10N �,;fARGES <br /> �� Y[AR '�-!i TRUNK S ��• �� <br /> k��.� � LATERAL �� <br /> TOTAL CONNECTION CIIARGFS E ��� <br /> �.;� -- <br /> �'� $EW[R PERMIT rEE S ��_ <br /> � , <br /> CATCH B�SIN PEHMIT FE[ .�� <br /> TOTAL SEWFR ('ERMIT F[[5 � .."L�•�� <br /> i; 1 <br /> , (7) MONTHI.Y S[WCR CII�RGE5: <br /> SEW&R CONSTRUCTION TRUCK s <br /> I <br /> LATER�L <br /> t S[WER SERVICE <br /> APPROX LOCATION Of SIDE SEWER OR TEE IN THE MAIN: <br /> _._ CNAHT _ — <br /> ;+ INFOCOMPILEDIIY: _ — �-��T� - <br /> ��' APPROVAL. D�TE <br /> �� <br /> ��' <br /> E <br /> , <br /> 1 <br /> � rie� <br /> � <br />