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ENGINEERING DEPARTMENT
APPLICATION AND COST ESTIMATE OF
SANITARY SEWER LATERAL CONNECTION
(bewer -
PART 1 - TO BE COMPLETED BY APPLICANT
WER LOCATION
ADDRESS
LEGAL DESCRIPTION
OWNER
ADDRESS
BUILDING PERMIT PLAN CHECK NO
ASS PARCEL NO
CONTRACTOR ^
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PART 2 - TO BE COMPLETED BY ENGINEERING DEPARTMENT
MINIMUM ABS SEWER PIPE IN PLACE - NOT TO EXCEED
10 FEET DEEP AND 30 LINEAL FEET HORIZONTAL DISTANCE
ADDITIONAL CHARGES FOR ANY DISTANCE EXCEEDING 30 LINEAL
FELT HORIZONTALLY
FEET AT PER FOOT
ADDITIONAL CHARGES FOR ANY DEPTH EXCEEDING 10 FEET
FEET DEEP AT PER FOOT
ADDITIONAL CHARGES FOR PLUGGING EXISITNG SEWER LATERAL
101AL CHARGES FOR CONSTRUCTION
ADDITIONAL CHARGES FOR CITY OF CARLSBAD SERVICES AT 507
OF ABOVE CHARGES
TOTAL CHARGES
1911 ACT A D NO DWG NO
$_
BY
PART 3 - TO BE COMPLETED BY UTILITIES DEPARTMENT
FOR SEWER LOCATION Main Depth
Lateral Depth at Property
SIGNATURES
UTILITIES DIRECTOR UTILITIES SUPERINTENDENT SANITATION SUPERVISOR