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FOR OFFICE USE ONLY <br />ADDRESS <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUM 31�G <br />(3) MECHANICAL <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PERMIT <br />$ <br />$ <br />(6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ <br />(A) TO BE DETERMINED BY BLDG. INSPECTOR INCH <br />(B) EXIST. WATER SERVICE. APPLICATION NO. <br />(7) STATUS OF SEWER CHANGES: <br />BONU DISTRICT FOOTAGE <br />N, S, / E, . W <br />SYS(EMS DEVELOPMENT <br />WATER <br />SEWER � <br />TOTAL ORD. FEE <br />SEWER COhNECTION CHARGES <br />YEAR TRUNK $ <br />LATERAL _ <br />TOTAL CONNECTION CHARGES $ <br />SEWER PERMIT FEE $ <br />