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ADDRESS �d%� 77%�a S-LU. TYPE S' <br /> 331 . 0 <br /> (1) BUILDING PERMIT FEE �`����� '� $ 0Po1� S'19�3 <br /> (A) PLAN CHECK FEE I4�Oa <br /> (2) PLUMBING 22 5Z) <br /> (3) MECHANICAL �� �o <br /> (4) 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 /> (C) APPROX. LOCATION ' <br /> 3' W aE 6k. .,� 1 r CHART <br /> (5) DRIVEWAY PERMIT TO BE PAID PRIOR TO BUILDING PERMIT IS- 10' 00 <br /> SUANCE 20 FEET DRIVEWAY(TYPE) $ _— <br /> $ <br /> (7) STATUS OF WER CHARGES: <br /> BOND DISTRICT 40 FOOTAGE <br /> N, S, E, W <br /> NOTES <br /> � C <br /> oor_-> (vCu9-8 U <br /> SEWER CONNECTION! CHARGES <br /> YEAR ot TRUNK $ <br /> LATERAL <br /> TOTAL CONNECTION CHARGES pp $ <br /> "I <br /> SEWER PERMIT FEE O $ <br /> CATCH BASIN PERMIT FEE .�1 Ic' I <br /> TOTAL SEWER PERMIT FEES $ 'O� <br /> (7) MONTHLY SEWER CHARGES: OUZO <br /> SEWER CONSTRUCTION TRUCK $ <br /> LATERAL <br /> SEWER SERVICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: <br /> t,PP�Rx LE3 � r W Q /Z '7- <br /> CHART <br /> INFO COMPILED BY: DATE <br /> DATE <br /> APPROVAL: <br /> 4179 <br />