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" �' AND UTILITY CONNECTIUN PERMIT
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c�xor�:LicxnseNo. Date
Farmit Valuatio� Partc Su�ort Fee # S
Permit Fce S 7 "? s SAC # $
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Pian Check Fee S Water Met� Size 5!8"; 1"; S
�� � G-t) Fress�reR�educea' S
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PenaIty S Sewu/VfTatr.r Coanection Fee # $
Plumbing Pennit Fee $ Wata Tower Fee # S
J�[er�aicat Pc�rmitRee $ Bnilc�er's Deposit S
Sewer & Water Permit Fee S (hher S
ras Fireplace Permit F� � '!O'i'AL DUE S �� _
� Yo�+r Pram4t'YV�ca Appmved Paid Rece' No.
Date B �'"
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