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HomeMy WebLinkAbout1140 CAPE AIRE LN; ; SE680272; PermitCITY OF CARLSBAD BUILDING DEPARTMENT SEWER PERMIT - APPLICATION FOR APPLICANT TO FILL IN LEGAL >/_ DESCRIPTION LOT NO. jT~ BLOCK TRAC'LJAXTjC.^U-Mj'.fcXT USE OF fN fj \) BUILDINGS dJLoC/-JC- * CONTRACTOR^ K £~~~~^ ADDRESS CITY C&AJc^^OtZ* CONTRACTOR'S STATE LICENSE NO. 6^_^o-*^>»«-<^ ; ^N, /** X?(TEL. NO. ^CARLSBAD BUSINESS LICENSE NO. NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO -p _^4 PUBLIC SEWER 9 ,$3.OO ^_> Q'C-' SEPTIC TANK, SEEPAGE PIT OR PITS ® S5.OO OVERFLOW SEEPAGE PIT, DRAINFIELO EXTN., CESSPOOL. DRYWELL. MANHOLE ® SS.OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ *1.5O CONNECT ADDITIONAL BLDG. OR ALTER. REPAIR OR ABANDON HOUSESEWER OR DISPOSAL SYSTEM @ S2.OO • * OWNER'S AUTHORIZATION 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW OWNER OR ADDRESS fr^d6Zt=ZL PERMIT $ 2 OO_ TOTAL FEE ^J~< C^'C^ CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD- ER. QA_Y OF ,.,_... 7> 1 HEREBY 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 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- ERTY. stx*~'st^SIGNATURE /jtt \XX*7 OF PERMITTEE e/^ feff*^ 7 '2 m ?9~69 - cc 2779******bU.OO BU.LDING / ///^m ^'^a i" r-c^TTO*^ * « ADDRESS / / *•-?• C-' <•— -<C Jfi*C ( £ ! t,^ (7 <}~-r\ , NEAREST /^7 // 7 /) ^, CROSS ST. CA~S^£{^7.'?.i,-t,3L- *^*f-^Tr OWNER I ••')l_ ,-J—j, j_ ^T> ^ <$—*4^>-Oi^<-—f\f MAIL ADDRESS CITY TEU. NO. CONNECTION DATA Lateral Charge Computation 30' H., 10' V. © 4" — h" — AJJ Hnrb (H) 4" — k" — Add. Vert. © 4" — h" — Total Constnirtinn O<^t 10% Servirs Charge Total 1 fltera! Charge Lat. No.: Logged in Plat: LINE COST DATA A. D. & Assmt. Nn_ 1 INF CCW- . J/ M/d? /*\ £& *£?{") QQC. C. © 3 w* / dwelling >_i w'' ** P. S. © _ .. / dwelling / * OTHFR // TOTAI^^OiOO Grand Total, lateral, etr. 5O »OO FOR SEWER LOCATION ,-St. NORTH ENSINf^tRIN^j SEWER DEPT. Signed ^> / . \ 7 i 1 Signed ' This is a Sewer Permit When Properly Filled Out, Signed and Validated I»MB<4 Rv O.lU PERMIT VALIDATION