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, � � ' . <br /> BUILDIiVG PERMIT INfORk1ATION <br /> ADDRESS TYPE <br /> (1) BUILDING PERMIT FEE b _ 'ISSoO� <br /> (A) PLAN CHECK FEE �� 55.�5 ' »6 � � l L <br /> (2) PLUMBING ��s �G <br /> (3) MECHANICAL �� SO <br /> (4) WATER SERVICE TO RF PAID PRIOR TO DUILDING PERMIT ISSUANCE �0�� <br /> (A) TO BE DETERMINED BY [1LDG INSPECTOR 3' INCH <br /> (B) EXIST WATER SERVICE, APPLICATION NO <br /> (C) APPROX. LOCATION <br /> CHART <br /> . (5) DRIVEWAY PERMIT TO Bf. PAID PRIOR TO BUILDING PERMIT IS• <br /> SUANCE _ FEET DRIVEWAY (TYPE) S c? Ut�— <br /> 3 <br /> p) STATUS OF SEWER CHARCES: <br /> BOND �� DISTRICT _ fOOTAGE . _ <br /> N, S, E, W <br /> , NOTES ' <br /> i � ��- s� - <br /> � so <br /> wa�l P. � 7, 0° ) 5 <br /> � <br /> ; Scwr. �-J� � "" <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK S 33a �a <br /> LATERAL <br /> ;� 1OTAL CONNECTION CHARGES S �-3a �� _ <br /> �; <br /> ! SEWER PERMIT FEE s 3fJw- <br /> CATCH BASIN PERMIT FEE <br /> TOTAL SEWER PERMIT FEES S _— <br /> p.: (7) MONTHLY SEWER CHARGES: <br /> ° SEWER CONSTRUCTION TRUCK s — <br /> LATERAL <br /> � SEWER SERVICE <br /> APPROX LOCATION OF SIDE SEWER OR TEE IN THE MAIN. � <br /> 1°' ; <br /> ` CHART <br /> :�'r, <br /> :? <br /> ;� INFOCUfviPILEDBY DATE _ <br /> s�+ APPROVAL DATC <br /> t. <br /> '. <br /> e <br /> :� <br /> nn <br /> . . -,.. . .. � � <br />