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n <br />BUlLDING PERMIT INFQRMATIOId <br />,J <br />ADDRESS _ � It�- r,`.,-� � ,.�.(._ t.-�. <br />(1) BUILDING PERMIT FEE <br />(A) FLAN CHECK FEE <br />(2) PLU�1BING <br />(3) MECHANICAL <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PER�'IT <br />� - -'-��L- � �� ��_ <br />—_� -I �� ' � <br />z ��-',c� <br />�J <br />1 � —" <br />S - ���,1��(!l '= <br />(o) WATER SERb'ICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE S - <br />(A) TO BE DETERMINED BY BLDG. INSPECTOR _ ���� INCH <br />(8) EXIST. ___ _ WATER SERVICE APPLICATION NO. <br />(7) STATUS OF SEWER CIIARGES: <br />BOND ,_I DISTRICT FOOTAGE <br />N. S. E W <br />ORDINANCE 1171•85 <br />WATER <br />SEWER <br />TOTAL ORD. FEE <br />SEWEN CONNECTION CHARGES <br />YEAR TRUNK <br />LATERAL <br />fOTAL CONNECTION CHARGES <br />SE1h'[R oERMIT FEE <br />� �� � �� ( :�. <br />L � (�i <br />(�, l�'� ,�, i! i� f' <br />�x' <br />- �- . � <br />` � �-�1�- <br />�l <br />� f <br />Ct�� l _� <br />� <br />s — — ����Q <br />��I ���ti <br />S � <br />