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w� <br />BUILDING PERMIT INFORMATION <br />ADDRESS _ _ <br />�' ) BUILDING P[RMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(41 STATFSUR�HARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PERMIT <br />,� 7 �'" J i .i'ct/ _ _ __ <br />(6) WATER SERVICE TO BE PAID PRIOF TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDG. INSPECTOR ___ _. .I_�� ___- INCH <br />(B) EXIST. ____- WATER SERVICE APPLICATION NO. _ ___ <br />(7) STATUS OF SEWER CHARGES: <br />BOND__z_.—DISTRICT_ __ _.. ____ FOOTAGE________ <br />N, 5, E W <br />( re�+re�(� <br />ORDINANCE 1171•85 <br />WATER <br />SEWER <br />TOTAL ORD. FEE <br />$ --- --325��— <br />---�.- zL-- <br />- -��nR <br />— /�1 GfJ — <br />_ '{cS0 <br />1 6iDii <br />$ — — ��'-7L <br />5 <br />I 3G�DG <br />— --�- --J.�z R� <br />�}' .__ ���q'` <br />_�-e-�-.5_ga.ce <br />SEWER CONNECTION CHARGES <br />YEAR TAUNK 5 - - - <br />LATERAL _ -__ <br />TOTAL CONNECTION CH�RGES $ — <br />SEWER PL-RMIT FEF <br />s 30 � <br />j Zu0�7L <br />