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ADDRESS _ <br />(1) BUILDING PERMIT FEE <br />(A) PLAN CHECK FEE <br />(2) PLUMBING <br />(3) MECHANICA'._ <br />(4) STATE SURCHARGES <br />(A) BUILDING CODE <br />(B) ENERGY CODE <br />(5) DRIVEWAY PERMIT , <br />FOR OFFICE USE ONLY <br />) <br />(6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE <br />(A) TO BE DETERMINED BY BLDG INSPE TOR INCH <br />(B) EXIST. _WATER SERVICE. APPLICATION NO. <br />(7) STATUS OF SEWER CHARGES: <br />BOND DISTRICT FOOTAGE <br />N, S. E. W <br />SYSTEMS DEVELOPMENT <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 />$ <br />�1r�Z <br />014 <br />/Z 9� <br />$ .J 0 <br />$ 7D <br />