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DEPARTMENT OF COMMUNITY DEVELOPMfNT SERVICES <br />BUILDING PERMIT INFORMATION <br />no�REss — nr� C�c,�-.��,, , - <br />.; <br />(1) BUILDING PERMIT F[E �9�t���'6 5 �-C�>•OC� _ <br />(A) PLANCHECKFE� _ I,•`�`� ��" <br />(2) PLUMBING '�� ���� <br />(3) MECH�NICAL ?7 c'� <br />(4) WATFR SERVICE TO fi[ PAID PRIOR TO EIUILUWC; Pf RMIT ISSUANCE <br />,_, � r.� r.u. <br />(A) TO RE DETERMIN[D EiY BLDG INSPP.CTOR � INCH <br />([3) EXIST. WATER SERVICE, APPUCATION NO. <br />(C) APPROX.LOCATION �'' � -� N"""� ��'��'��'� �`i r' <br />S er �. c� IIZn.S� ' CHART `:�- �'->`I� <br />(5) DRIVEWAY PERMIT 10 [3C: PAID PRIOR i0 BUILDING P[RMIT IS- <br />SUANCE _ FEET DRIVEWAY(TYPE) S <br />i <br />(7) STATUS OF SEWER CHARGES: <br />[30ND �---�ISIRICT <br />NOTES <br />:t-�i��=s�. fx`�i. �t�__-. <br />O��n. "Ii �. - H � � <br />�..�eC� 7 � <br />�.�-1_ �l'�. f' I =' I�l -1 I, lc A <br />FOOT�GL � �'� <br />LJ S' E' W <br />y� ! <br />?�,G --- • <br />C�i F-rti'cu» i�� p,�_tr.zai, <br />� � �7L . � ��iJiKlk1l. <br />U)�� <br />� <br />SEWER CONNECTION CHARGES <br />YEAR Fi `'� TRUNK 5 ���' �'� <br />LATERAL ���' � 4 � <br />TOTAL CONNECTION CHARGES S �'''�' '4c� <br />SEWER PERMIT FEF. <br />CATCH UASIN PERMIT FEE <br />TOTAL SEWER PERMIT FEES <br />� <br />(7) MONTHLY SEWER CHAkGES', <br />SEWER CONSTRUC110N TRUCK f <br />LATERAL <br />SEWER SERVICE , <br />APPROX LOCATIONOFSIDESEWERORTEEINTHEMAIN: '�� �'G�� <f �r ����" "` <br />,� n <br />`.� G� Lnr.. j'� 1'I P��ncv 1�4 rT � 9c� r, u-�cr..- c�r t,� �-� _ <br />�' 1�c�F-�c>r. Y� t-r C �' <br />CHART `'�-� 4 - ? E� - �, <br />---� <br />INFO COMPILED UY. <br />APPROVAL -- <br />91 )9 <br />UATE <br />DATE <br />