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HomeMy WebLinkAbout1170 CAPE AIRE LN; ; SE680275; PermitCITY OF CARLSBAD BUILDING DEPARTMENT SEWER PERMIT - APPLICATION FOR APPLICANT TO FILL IN j Lf? O ^ AUG 29-68 8?£r2769****** LEGAL r*V DESCRIPTION LOT NO. / BLOCK TRACT Lj&4frtU-^.^J}C-£i3( USE OF (; "*! fj (/ BUILDINGS ^ke^C^J-TT CONTRACTOR /f^T^ ^\^-^-^J~C^-J<) ADDRESS ^ CITY CL<-^^^I TEL. NO. CONTRACTOR'S/STATE CARLSBAD BUSINESS LICENSE NOT LICENSE NO. NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO --? xf..^ PUBLIC SEWER & »3.OO _> 0>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 @ $I.5O CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER @ $1 SO ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.OO @ * OWNER'S PERMIT * ? OO_ AUTHORIZATION TOTAL FEE <jT ©O 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- ING TO THE PUBLIC SEWER. OWNER OR ADDRESS — — 1 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. 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. /,. „/•) SIGNATURE £&—&//) BUILDING / / *~> sTY ADDRESS // ,/^«SCJ s NEAREST XO //' * CROSS ST. ( X— ^!<L£L**tsl* ?W^F^^uf^U^^Y/gf^' OWNER /p£U^ /^^^~**t^-~&S<*-d/ MAIL IV" ADDRESS CITY/? *)?, ~^^ \\\\'*S' ^~ TEL. NO. C / CONNECTION DATA Lateral Charge Computation 30' H., 10' V. <§> 4" — h" — A.4,1 I I,.,,.;, fffl A." • Add. Vert. @ 4" — Total 10% Service Charge To Lat. No.: .. A" — ffll l_«tfirnl Ch^rfjA Logged in Plat: LINE COST DATA A. D. & Aismt. Nn LINE cnaT: C. C. @?O / dwelling „ *5Q,QQ P. S. &. / dwnlling OTHER . . _ Jl Grand FOR SEWER 00 TOTA) &j$0*OQ fotal, l«tnr«l, «tr ^OO 'O(j LOCATION NORTH SEWER DEPT. Signarl CtA S^| I $\ynKA 6.00 This is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION