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DE�ARTMEHT OF �OA;MUNITY DEVELOIMENT SERVICFS <br /> BUILDING PERMIT INFORMATIdN <br /> ADDR[S� - Z L I ('�� Ti r �-T S. � • _TYPE �uu�-E= ��M�L'-,' �-5 <br /> (1) BUILDING PERMIT FEE ��E�Y�J- �` S � �'�- � � <br /> (A) PLAN CHECK FEE �p ,� "b�•S <br /> (2) PLUMBINC �'� <br /> (3) MECHANICAL 5�5Z-'____ <br /> (4) WATER SERVICE 70 BE PAID PRIOR TO BUILDINC PERMIT ISSUANCE LOO• D<_)__ <br /> (A) TO BE DETERMINED BY ULDG INSFECTOR 3� INCH <br /> (H) EXIST. WA7ER SERVICE, APPLIrATION NO. <br /> (C) APPROX. LOCATION — <br /> CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BL'ILDING PERMIT IS- <br /> SUANCE _ FEET DRIVEWAY(TYPE) S ��� `�� <br /> ' b <br /> (7) STATUS OF�EWER CHARGES: <br /> BOND �� DISTRICT �=00TACF <br /> N, 5, E, W <br /> NOTES <br /> ��� G��TI�i rr ��� <br /> �O /%7/ —�j � <br /> �.�'� <br /> �.12 � l7�j � O � <br /> ,>tZU� 4 71 • `�r� <br /> �� OL� 5[WER CONNECTION CHAKGES � <br /> Y'EAR g� _1 RUNK 5 ' � �� <br /> LATERAL <br /> 1OTAL CONNECTION CHARGES s _-�3D=(9 v <br /> SEWER Pf RM1T FEE S �0� �D <br /> CATCH BASIiJ PERMIT FEE " <br /> TOTAL SEWER PERMIT FEFS S Z��/� <br /> (7) MONTHLY S[WF.R CHARGES: <br /> SEWER CONSTRUCTION TRUCK s <br /> LATERAL <br /> SEWLR SERVICE <br /> APPROX. LOCATION OF SIDE SEVVER OR TEE IN THE MAIN: <br /> CHART_ <br /> INFO COMPILED [3Y: DATE <br /> APPROVAL: _ — DATE <br /> s oa <br />