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L"MRTMENT OF COMMUNITY DEVLL0FmtNl slk�IUS <br /> BUILDING PERMIT INFORMATION <br /> S L1.) TYPE <br /> 0;7 o a <br /> ADDRESS s ��, $ <br /> (1) BUILDING PERMIT FEE Co 4, r d" ` 'o P4 <br /> (A) PLAN CHECK FEE /4. U <br /> (2) PLUMBING 71:7• `'� <br /> (3) MECHANICAL !v!) 00 <br /> (q) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br /> (A) TO BE DETERMINED BY BLDG INSPECTOR 17 <br /> INCH <br /> (B) EXIST. — WATER SERVICE, APPLICATION NO. <br /> 1JI <br /> (C) APPROX. LOCATION �^""z—`' <br /> w µ - C'� Lr -r CHART <br /> LF <br /> Z1 <br /> (5) DRIVEWA`' °ERMIT TO BE PAID PRIOR TO BUILDRIVEWAY <br /> R VEWAY(TYPE) $ `7' <br /> SUANC ' / --FEET _ $ -3 -Ou <br /> (7) STATUS OF SEWER CHARGES: FOOTAGE <br /> BOND DISTRICT <br /> N S, E, W <br /> NOTES <br /> A` Sc=wcT� GWA.f'"etl ::s <br /> LoLoq- 8 " <br /> b.r , 1 <br /> c <br /> SEWER CONNECTION CHARGcS r/I , L7 0 <br /> YEAR E1 ( TRUNK $ <br /> LATERAL $ !�c� .oy <br /> TOTAL CONNECTION CHARGES <br /> gl���� <br /> SEWER PERMIT FEE �- <br /> CATCH BASIN PERMIT FEE n 3c1q3$ �C. 6)U <br /> TOTAL SEWER PERMIT FEES ✓` _�— <br /> (7) MONTHLY SEWER CHARGES: $ © 2C) <br /> SEWER CO'JTRUCK STRUCTION LATERAL <br /> SEWER SER\ ICE <br /> APPROX. LOCATION OF SIDE SEWER OR TEE IN THE MAIN: - <br /> _�_ CHART <br /> DATE <br /> INFO COMPILED BY: DATE <br /> APPROVAL: <br /> 9-1-79 <br />