HomeMy WebLinkAbout2001 BASSWOOD AVE; ; SE669265; PermitTHIS DATE A CONTRACT WITH THE HEREIN % R TO CONNECT THE ABOVE DESCRIBED BUILD- WE PUBLIC IEKwER.
I I U/ BUILDIMG ADDREW 7-0
NKAREST CROSS -ST,
OWNER
MAIL ADDRESS
CITY TEL NO.
CONNECTIOM DATA Irierel Cherge Compwtdon
30 H., IO' V. 8 4" = - 6" = -
Add. Horiz. @ 4" = - 6" = -
Add. Vert. 0 4" = I_ 6" = -
Total Construction Cost
10% Service Charge
Total lateral Charge
bt. No.: Logqed in Plat:
LtNE COST DATA
A. 0. L Assmt. No.
LINE COST:
C. C. @L / dwelling @
P. S. 0- / dwelling
OTHER
TOTAL
Grand Tofa!, lobrid, ek. ri/ FOR SEWER LocAnoN I,
ENGINEERING SEWER DEFT.
signed , I Signed
Hlkd
APPROVALS I DATE I INSPECTOR'S SlGNATURl
UNDER FLOOR WORK
ROUGH PLUMBING
GAS PIPING
GAS VENTS
PLUMBING FIXTURES
MISC.
GAS TEST
UTILITY CO. NOTIFIED
FINAL