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r- <br />BUILDING PERMIT INFORMATION <br />ADDRESS <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICAL <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PERMIT <br />$ <br />$ <br />(6) 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 />(7) STATUS OF SEWER CHARGES: <br />BOND_ __ DISTRICTFOOTAGE <br />N, S, E W <br />ORDINANCE 1171-85 <br />WATER <br />SEWER <br />TOTAL ORD. FEE <br />SEWER CONNECTION CHARGES <br />YEAR _ . _ _ TRUNK $ __ <br />LATERAL ___-- <br />TOTAL CONNECTION CHARGES <br />SEWER PERMIT FEE $ <br />