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� �� <br />DEPARTMENT OF COMMUNITY DEVELOPMENT SERVICES <br />BUILDING PERMIT INFORMATIO�1 <br />ADDRE55 G'�'� 74�''-� ��T S lG� __ TYPE _ <br />(1) BUILDING PERMIT FEE �.:'EcrC'• ```� <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDG INSPECTOR �f�__ INCH <br />(B) EXIST. VVATEfi SERVICE, APPLICATION NO. _ <br />(C) APPROX. LOCATION �'� ��� �% �%%���'%y ���.v <br />� �: <br />E 2�i• So <br />l� •00 __ <br />l¢; C�D <br />lvo -Od <br />CHART — <br />(5) DRIVEWAY PERMIT TO BE P�ID PRIOR TO BUILDING PERMIT IS- <br />SUANCE 2 5^ FEET �G����• DfiIVEWAY(TYPE) S �2' � U <br />b <br />(7) STATUS OF SEWER CHARGES: <br />BOND � _ DISTRICT _ <br />NOTES <br />FOOTAGE <br />N, S, E, W <br />SEWER CONNECTION CHARGES <br />YEAR 8 z TRUNK <br />LATERAL <br />TOTAL CONNECTION CHARGES <br />SEW,:K PERMIT FEE <br />CATCH BASIN PERMIT FEE <br />iOTAL SEWER PERMIT FEES <br />(7) MONTHLY SEWER CHARGES: <br />SEWER CONSTRUCTION <br />� 270 • r�v <br />E Z 7U . OU <br />S 3O'�O <br />s �. cZ <br />TRUCK S <br />LATERAL <br />SEWER SERVICE <br />APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: �'�T To p'�- d0o/Lo" <br />(- �a�T �- ��F SlU Gc2 UF L.oi � ht'PRG7 (IIPZ ��,l� <br />CHART �- - IZ-- 28''-� <br />INFO COMPIL[f) BY: <br />APPROVAL: _ — <br />41�'9 <br />DATE <br />DATf <br />. <br />i <br />4 <br />n <br />� <br />