Laserfiche WebLink
� ui ��eNc ���n���r rr� �o�r���io� <br /> HC� � <br /> � � x ADDRESS —_������ ��� �� ��� �'� � TYPE <br /> $ �.� ��+ `-�-� <br /> � � � (') BUILDING PERMIT fEE _ <br /> � � (A) PLAN CHECK FEE �� �,r <br /> � �� (2) PLUMBING �o��-, <br /> � (3) MECHANICAL � � <br /> y cx� <br /> �i o (4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE ��� _.n — <br /> o H e (A) TO BE DETERMINED 8Y BLDG INSPECTOR ''� � INCH I =� �— <br /> 0 <br /> � <br /> �� � (d) EXIST. _ �'ATEft SERVICE, APPLICATION NO. <br /> � y� (C) APPROX. LOCATION <br /> z <br /> HH <br /> g v' H CNART <br /> o t7 rn <br /> � [� � (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- rt� <br /> yo � SUANCE FEET ORIVEWP.Y(TYPE) S �%�� <br /> � <br /> (7) STATUS OF SEWFR CHARGES: <br /> 80ND ��ISTRICT FOOTAGE — <br /> N, S, E, W <br /> NOTES <br /> If ��71-;' �� 17G � I-2a'il�,� <br /> j �-71 ��'_ t� _. <br /> �����(l�� i�. <br /> �� <br /> I,.r j1 �'- <br /> � � <br /> �ef <br /> i j SEWER CONNECTION CHARGES � � �y-� <br /> YEAR TRUNK � > >��' <br /> �+� <br /> LATERAL �r, <br /> t_� �`s��- <br /> TOTAL CONNECTION CHARGES 5� <br /> �9 ,�, c�n <br /> �� SEWER PERMIT FEE $ ` _ <br /> " CATCH BASIN PERMIT FEE ���_, <br /> �� TOTAL SCWER PERMIT FEES $ _ <br /> o (7) MONTHLY SEWER CHARGES: <br /> �� SEWER CONSTRUCTION TRUCK $ <br /> �' LATERAL <br /> a <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE �N THE MAIN: <br /> CHART <br /> INFO COMPILED BY: DATE <br /> DATE _ <br /> APPROVAL: <br /> ,.s.: <br />