Laserfiche WebLink
L-OT 1 <br />.,. 1�1 1,\f \JI\,\lH 11V 1v <br />ADDRESS <br />TYPE OF' BUIL=:G �� �. ,DAT'E <br />1) BUILDE\O PERI:IT FE-E 2v 70-�- s_ I oL4, Od <br />(A) PLAN CHECY, FEE $_ ?I Le -DO <br />2) WATER SERVICE TO BE PAID BEFORE BUILDING <br />PERMIT IS ISSUED �j <br />(A) TO BE DETER. LNED B'i PLBG. INSP. J INCH <br />(B) EXIST. WATER SERVICE, APP . ///NBo <br />C. <br />(C) LCC�ATIION S7-414 / <br />%O J Fir V eV / _ <br />Cam- _CHART 5 _ t� <br />S i DRIVEWAY PERMIT TO BE PAID BEFORE EC1LDi:,G <br />PERL:IT IS ISS IED SFT. ,/' <br />0 '1' iTYPE1 <br />TCTAL <br />S T A*7: 7S OF SEWER CILARGES: <br />1',CI:D-EU: DISTRICT �_l FOCTAGE <br />SEWER CCNNECT:CX CHARGES: <br />TF.UNY. <br />LATERAL <br />TOTAL CCNNECTION CHARGE <br />SEWER PERMIT FEE <br />CATCH BASIN PER.M,17 FEE <br />TOTAL SEWER PERMIT FEES <br />5) MONTHLY SEWER CHARGES: + <br />SEWER CONSTRUCTION: <br />TRUNK <br />LATERAL <br />SEWER SERVICE: <br />LOCATION OF SIDE SEWER ORE IN MAIN: CHART L <br />/% <br />INFO COMPILED BY <br />REVIEW: <br />APPROVAL: <br />This total must be paid before building permit is issued. <br />S 1,00, U Cd <br />S %So <br />S 19 jV <br />$ <br />S <br />5 <br />1O.O o <br />S <br />S <br />,30, 0 0 <br />$ <br />a�- <br />$ <br />$ <br />a�sa <br />DATE <br />DATES�� 7S <br />DATE S-�/? .7l` <br />