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HomeMy WebLinkAbout1155 CAPE AIRE LN; ; SE1968; PermitCITY OF (ARUBAD BUILDING DEPARTMENT SEWER PERMIT. APPLICATION FOR APPLICANT TO FILL IN LEGAL / A DESCRIPTION LOT NO. / U BLOCK TRAcC^2/^*/ ^-^ USE OF "7^ -* t-^ i/BUILDINGS '/£-' 1s<s\ CONTRACTOR S?{'?~^'j^ * ' /~) V ADDRESS CITY l_^£^&4~\ LICENSE NO. ^- -^ TEL. NO. CARLSBAD BUSINESS LICENSE NO. NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO -*& jri s?) PUBLIC SEWER @ $3.OO JT f;'O SEPTIC TANK, SEEPAGE PIT OR PITS @ $5.OO OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN., CESSPOOL. DRYWELL. MANHOLE @ $5.OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.5O CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER @ $1 5O ALTER. REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.OO @ $ OWNER'S AUTHORIZATION 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW OWNER OR ADDRESS PERMIT $ 2 OO TOTAL FEE Q\C'\^J CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD- ER. DAY OF 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, sfn s^x SIGNATURE /7/^7'^y OF PERMITTEE 1 ' i nuu c_ 7 uo - CC *- ' ' ' Allfi 9O-fiQ 5 ?T7£****** BUILDING S/<~-£T~/*i st " *C- ADDRESS // 3 0 ^ ^>%.4@S LsC^C-4-^f <f~i^l NEAREST /~~£ /) ^.tsJL ^^O^ OWNER y^^^T^S^^-t^Z^tl^MAIL ^^ ADDRESS CITY ^^^^J, TEL. NO. ^Z^ CONNECTION DATA Lateral Charge Computation 30' H., in1 V (5) 4" — A" — Add. Vert. © 4" = _. A" — Total Construction C^st „ ,» ,. ... .._ 10% Service Charge Total 1 atfirnl Chnrgo Lat. No.: Logged in Plat: LINE COST DATA A. D. X Assmt Nn LINE COSA>- I, C. C. </50 , d^ltng ^5^.00 P. S. ©_ .. . / dwelling OTHFR ^ TOTA, ^60,00 Grand Total, Latnral, etr. « 50 >OC FOR SEWER LOCATION V CO A f^t. NORTH ENGI/WERLN®^ SEWER DEPT. Signed (X-/- Uf 1 I SignBrlV 1 This is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By .. .... . . , ^U.OO *s no PERMIT VALIDATION