HomeMy WebLinkAbout2618 WILSON ST; ; SE676727; PermitCITY OF CARLSBAD SEWER /8'-/, ~~
BUILDING DEPARTMENT ~ •
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PERMIT • APPLICATION
FOR APPLICANT TO FILL IN '2D
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LEGAL BUILDING Q fc/9" lv { 1 10. ?1 ')'i~ DESCRIPTION LOT NO. ADDRESS
•5.00
BLOCK TRACT NEAREST
CROSS ST. Fo,t.c 7 AVc. I
USE OF
OWN ER 86et T G1LU,t.,G#A,¥} BUILDINGS
ow 'vl e r MAIL 2618 WILSoV ST, CONTRACTOR ADDRESS
ADDRESS CITY TEL. NO.
CITY TEL. NO. CONNECTION DATA
CONTRACTOR"S STATE CARLSBAD BUSINESS Lateral Charge Computation
LICENSE NO. LICENSE NO. 30' H., 10' V. @ 4" -__ 6" -----
Add. Horiz. @ 4" -__ 6"
NO. DESCRIPTION OF WORK FEE ----
HOUSE SEWER CONNECTING TO ~ ~o Add. Vert. @ 4" -__ 6" -
PUBLIC SEWER @ $3.00 ----
SEPTIC TANK, SEEPAGE PIT OR Total Construction Cost t./5,00
PITS @ $5.00 //,50 OVERFLOW SEEPAGE PIT, DRAINFIELO EXTN., I 0% Service Charge
CESSPOOL, ORYWELL, MANHOLE @ $5.00 ;26,SO HOUSE SEWER CONNECTING TO Total Lateral Charge
PRIVATE DISPOSAL SYSTEM @ $1.50 /515 CONNECT ADDITIONAL BLDG. OR Lot. No.: Logged in Plot:
WORK TO HOUSE SEWER @ $1.50
ALTER, REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM @ $2.00 LINE COST DATA
@ s A. D. & Assmt. No.
LINE COST· I/
C. C. @<§a / dwelling &.,:;(") ~
I s 2 00 OWNER'S PERMIT
AUTHORIZATION TOTAL FEE 500 P. S. @ __ / dwelling
OTHER
7~,N I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILO-TOTAL ING TO THE PUBLIC SEWER. 776,-5 )
SIGNED THIS DA.FA Grand Total, Lateral, etc.
g~~~~-i~GENT ~A t -~ ~t-.
ADDREss i 6. l w 1 >--s " ,u s r FOR SEWER LOCATION
I HEREBY ACKNOWLED GE THAT I HAVE READ THIS
APPLICATION AND STATE THAT T HE ABOVE IS CORRECT + + AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND V) V)
STATE LAWS REGULATING PLUMBING AND SEWERS.
E~CJINJt. fl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS-NORTH
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP.. SEWER DEPT.
ERTY. Signed 7 7 / r-/ ,L.,. L,, SIGNATURE i Signed OF PERMITTEE I/ I/I
This is a Sewer Permit When Properly Filled O~~nd
Issued By ----~"-'o.,.,,c..."""";....___. _________ _
A "" } ' JJ A. (\ / I PERMIT VALIDATfoN
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Validated