Loading...
HomeMy WebLinkAbout1089 CARLSBAD VILLAGE DR; ; SE1969; PermitSEWER PERMIT - APPLICATION 1 FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO BLOCK BUILDINGS CONTRACTOR A-'* A D * TRACT "0^ /lO&oST&ltS ADDRESS CITY CONTRACTOR s STATE LICENSE NO TEL NO CARLSBAD BUSINESS LICENSE NO NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ S3 OO SEPTIC TANK SEEPAGE PIT OR PITS @ S5 OO OVERM_OW GLCFAGE i IT DRAINFIELO EXTN CrSSPQoi DRYV ELL MANHOLE @ S5 OO HOUSE SEWEP CONNECTING TO PRIVATE DISPOSAL SYSTEM @ SI 5O CONNECT ADDITIONAL BLDG OR ALTi_R REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ 32 OO @ S OWNER'S AUTHORIZATION 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SE\A, OWNER OR PERMIT S TOTAL FEE / /^}A^y S o {£, *' \£>2 <s&X| CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD ER 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT i AM THE LEGAL OWNER OF THE ABOVE ' DESCR1 BED RESIDENTIAL PROP- ERTY / s IS i ' SIGNATURE 1 / / f, I • ' BUILDING / -« t?£t -" j ADDRESS fCjQ^Ji /~{_-r*-'i H t/ £• NEAREST CROSS ST |5 (X (^ t- UJ A "V OWNER 7"/£" K S} <?G /A/ C. MAIL ADDRESS -^ CITY / TEL NO CONNECTION DATA Lateral Charge Computation . 30' H 10 V <Ti) 4" — ... A" - _ ^ //£*£- /^dd Vert © 4" — i" — Totfll Constnirtion C.nct 1 ££> O& VV-, Totnl Lnheral CharQS / 7&~ O O ^L0i rtfe^St^>\ In.n.H ,n Pl,"t 1 ^\*? ^ ?;nTINE COST DATA \N^% ^j cS^-^^^S^i^ii,^ Z-t-^J'-. S / OG G° ratpSCGBgOLS/ dwpll.nn OTHFR f TOTAI /^O ""-*"J ''/—~} S" POR SEWER LOCATION to </, St NORTH ENGINEERING SEWER DEPT <;,0n^ 1^ ^?^-,f~-j (lfj_e ^nnfj This is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION ^^|- -- irrTMfliiri'iiJll^''-"-fra*£jj^t'"iiaB^^