HomeMy WebLinkAbout1807 VALENCIA AVE | 1809 VALENCIA AVE | 1811 VALENCIA AVE | 1821 VALENCIA AVE; ; SE1896; Permit-
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
438-5541
FOR APPLICANT TO Fl LL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS:
J
ti;
, 1007
EXISTING BUILDING
I
LATERAL LOCATION
ST.
nc.
ti
LATERAL NO. _______ INSTALLATION DATE--------t1
ISSUED BY __________________ _
DATE ISSUED------------------
VALIDATION
I I
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10') _________ _
OVER 30' H. ___ @~._-___ FT. _________ _
OVER 10' V . @ FT. _________ _
STANDARD 6" (Max. H. 30', V. 10') _________ _
OVER 30' H. ___ @:.,.__ ___ FT, _________ _
OVER 10' V. @ FT,----------
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC.) ___ -,------..,.-
TOTAL LATERAL CHARGE ___ _:_ _____ _
LINE COST DATA
ASSESSMENT DIST. NO.---------------
FRONTAGE ____ COST PER FT. ____ TOTAL ___ _
OTHER ____________ _;_ _______ _
CONNECTION FEE
NO. UNITS ____ COST PER UNIT ____ TOTAL----
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ____ TOTAL---
' TOTAL CHARGES (LATERAL ETC.) __________ _
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