HomeMy WebLinkAbout1175 HOOVER ST; ; SE690075; PermitCITY OF CARLSBAD SEWER
BUILDING DEPARTMENT PERMIY • APPUCA 110N
LEGAL
LESCRIPTION
FOR APPLICANT TO FILL IN '----~ LOT NO ------
BLOCK
USE OF
BUILDINGS
CONTRACTOR
ADDRESS
CITY
TRACT
TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @
SEPTIC TANK, SEEPAGE PIT OR
PITS @
$3.00
$5.00
OVLHFLOW Sr EPAGE t'IT ORAINl IE:.LO EXlN,
CESSPOOL ORY\'✓CLL, MANHOLE @ $5 00
HOUSESEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM (f~ $1.50
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER ((J> $ t 50
ALTER REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM @ $2.00
OWNER'S
AUTHORIZATION I PERMIT
TOTA L FEE
2 00
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 THIS
APPLICATION ANO !;TATE THAT THE AOOVE IS CORRECT
AND AGREE TO COl,IPLY WITH ALL CITY ORDINANCES AND
STATE LAWS REGULATING PLUMBING AND SEWERS.
DUILDING
ADDRESS
NEARESY
CROSS ST
OWNER
MAIL
ADDl1ESS
CITY TEL NO.
CONNECTION DATA
L<1foral ChMge Computation
30' H., JO V. ri, 4" 6"
/\<.id. Horiz. 'ii . .. ~ 6"
Ado. Vort. 11 4" 6" =
Total Corstruciion
IO O Servi co C~arge
C I
To al Le• ral Charge
I~-. No.: L<'ggod in P!oi:
LIN E COST DATA
A. D. & Assmt. No.
LINE COST:
C. C. ri1
OTHER
.,.:
V)
/ dwelling
/ dwelling
TOTAL
Grond T -:,fol, L J orol, ot
FOR SEWER LOCATION
St.
. V)
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY THE CITY OF CARL S-
BAD AND STATE OF CALIFOHNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP·
ERTY. ENGi NEERING S~WFR DEPT.
SIGNATURE
OF PERM ITTEE S'gnod
This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION
-1
NORTH -,