HomeMy WebLinkAbout1150 CAPE AIRE LN; ; SE680273; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
SEWER
PERMIT - APPLICATION
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
USE OF
BUILDINGS
BUILDING
ADDRESS
73 AUG 29-68 !TT2767******bU.GO
6.00
ADDRESS
CITYt ^TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-
ING TO THE PUBLIC SEWER.
SIGNED THIS
OWNER OR
OWNER'S AGENT -
ADDRESS
DAY OF
I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION 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
NO.DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ ,$3
SEPTIC TANK, SEEPAGE PIT OR
PITS @ $5
OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN
CESSPOOL, DRYWELL, MANHOLE @ $5
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1
CONNECT ADDITIONAL BLDG. ORWORK TO HOUSE SEWER @ $1.
ALTER, REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM @ $2
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60
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@ *
OWNER'S PERMIT
*AUTHORIZATION TOTAL FEE
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CONNECTION DATA
Lateral Charge Computation
30' H., 10' V.
Add. Horiz.
Add. Vert.
Total
10% Service Charge
Lat. No.: _
Total Lateral Charge
Logged in Plat:
LINE COST DATA
Grand
FOR SEWER LOCATION
NORTH
Signed
This is a Sewer Permit When Properly Pilled Out, Signed and Validated
Issued By
PERMIT VALIDATION