HomeMy WebLinkAbout1140 CAMINO DEL SOL CIR; ; SE1971; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
SEWER
PERMIT - APPLICATION
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION
USE OF
BUILDINGS
CONTRACTOR
TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
DESCRIPTION OF WORK
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @
SEPTIC TANK, SEEPAGE PIT OR
PITS <i _$51OO_
OVE.RFL.OW SEEPAGE FIT. DRAlNFiELD EXTN.,
CESSPOOL, DRYWELL, MAhlHOLE @ S5.OO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER @ gl.SO
ALTER, REPAIR OR ABANDON HOUSE
SEVVER OR DISPOSAL SYSTEM @ $2.OO
OWNER'S
AUTHORIZATION
PERMIT SE
TOTAL FEE
2 OO
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-
ING TO THE PUBLIC SEWER,
— DAY OF .-SIGNED THIS —OWNER OR
OWNER'S AGENT — -•- — — — ~
ADDRESS ^_ — — -• _^ZT.
I HEREBY ACKNOWLEDGE THAT I 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.
I 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 DESCRIBED RESIDENTIAL PROP-
ERTY.
SIGNATURE
OF PERMITTEE • —
BUILDING
ADDRES_S
NEAREST
CROSS ST.
MAIL
ADDRESS
CONNECTION DATA
Lateral Charge Computation /O^L^f faC, \t/A f\ _ -f^ffl*^-' IT w)w<O""' "^^
30' H., 10' V. @ 4" = 6" — —__ . _..._
Total Construction Cost __
Total Lateral Charge __
Logged in Plat: „_
LINE COST DATA
A. D. & Assmt. No. —_. . „
LINE COST: .
C f~* fT-.-, ^^fr^f r i r I *. ( (tij^Jt£? / dwelhng ._ ..
TOTAL
Grand Total, Lateral, etc.
OO
FOR SEWER LOCATION
St.NORTH
ENGINEERING SEWER DEPT.
Signed
This Is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By _., „_..,_ —. ~___.. .
PERMIT VALIDATION