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J <br /> _M101111,11:1" :G Alm CO:I:•1U111.1•Y :1" <br /> 13UII.D111O PI:R!1r'I' 1111.-01MATIMI <br /> 1) <br /> vo <br /> 1:UII.UI!4G PIM:11T k')iL• $— /��JJz " - <br /> n) PLAN CMC1c Fl;li S 6A7d c <br /> z) PLUMBING $— / T <br /> 3) 14ECIIAIIICAL $ /5 <br /> 4) WATER SERVICE TO BE PAID BEFORE BUILDING <br /> PERMIT IS ISSUIiD <br /> (A) TO BE DETER14I?IED BY PLBG. INSP. <br /> (n) EXIST._ • wurn SERVICE, APDL. NO. <br /> � TT �/f �� �YQ•t'i.�.� O � <br /> (C) i+PPROX. LOCATION �/ ��y• /1 �i� <br /> '5 ,6-J. CHART (.0 - 0/ 3 <br /> 5) D?IVE.MY PP.T•SIT TO BE PAID BEFORE IIUIIDIIIG S �, • Sv <br /> PEWMIT IS ISSUED __Z2 FT. AS�,�- D/PI (TYPE) <br /> G) STATUS OF sE?JEER cBnl cL's: TOTAL $ <br /> DOND DISTRICT FOOTAGE <br /> N, 8, E, Pi. <br /> SEWER COMNECTION CHARGES <br /> NOTES ��pp <br /> YEAR �� TRUNIN S <br /> ,l LATERAL $ dD <br /> l�qo Il/���1 <br /> TOTAL CONMECTIO.J CHARGE$ 7 <br /> SE';ER PEMI'1` F1:E <br /> 1 CATCH BASIN PERItIT FEE $_ <br /> TOTAL SEQER PERMIT FEES$ ,�I °� •� <br /> '1) !iO:JTIILY SEWER �b C1IARGES: , <br /> SF•.IJER CONSTRUCTION: P TRUNK $ ZU <br /> -LATERAL <br /> SMIER SERVICE $ C50 <br /> APPROX. LOCATION or SIDE SE'JEA OR •TIiE IN TILE MAIN: <br /> ve <br /> CnnRT & r o <br /> xrlr•o ce:R`u.l:p ni <br /> DATRi <br />