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]MGIN►:ERING AHW C0;1:4U111TY SR►tVlCW'J <br />BUILDING PENN IT 1111`01MATTWI <br />1) BUILDING PER:IIT FEE <br />(A) PI,2\11 CBI cl, r• lai S, Za 3• SZ7 <br />2) PLUMBING <br />3) MECHANICAL $ /la OCR <br />4) WATER SERVICE TO BE PAID BEFORE BUILDING <br />PER;•II'P I.^, ISSUED <br />(A) TO BE DETER14INED BY PLBG. INSP. / INCH <br />Ml EXIST._ WATER SERVICE, APPL. NO. <br />(C) APPROX. LOCATIO14 <br />5) <br />6) <br />CHART jg6r l9C . peq <br />DRIVEWAY PERMT TO BE PAID BEFORE BUILDING <br />PERMIT IS ISSUED oS 7LFT. D/Sl (TYPE) <br />STATUS OF S1 [PER CHARGES: TOTAL $ 4 4 6 • '30 <br />BbND _DISTRICT J5 FOoTmE <br />N, $, El W. <br />SEWER COWNrCTION CHARGES <br />YEAR ?� TRUNK $ 2,2 ' <br />LATERAL $ <br />TOTAT, COYNGCTION CHARGE$ Ov <br />SMER PERMIT FEE <br />CATCH BASIN P.EWMIT FEE <br />TOTAL SEWER PER14IT FEES$ 30• &_� <br />•/) MONTHLY SEVIER CHARGES: <br />SEWER CONSTRUCTION: TRUNK <br />LATIiRAL <br />SEA'EII SERVICE <br />APPROX. LOCATION Or SIDEGE14M OR TEE IN THE MAIN: <br />INFO CONPILL••D BY: <br />Al•+"ROVAL: <br />CHART / l / DAy4. <br />nATE <br />DATH . <br />