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1318 CHUPAROSA WAY; ; SE669112; Permit
CITY OF CARLSBAD BUILDING DEPARTMENT SEWER PERMIT - APPLICATION rPAID28 66 5V231M*******5 00 FOR APPLICANT TO FILL IN LEGAL /•DESCRIPTION LOT NO f/ . r BLOCK / TRACT USE OF f*J / BUILDINGS /\ f f / (y^t-, fi 43 t CONTRACTOR jfl-L-, d •fS), S al ^ J~ f\ il D / ^1 J" O 'l ADDRESS 7 f"4^/ x> T -J r f J7 CITY (~ 0^-A McJ TEL NO 72-?-2'7//' CONTRACTOR S STATE CARLSBAD BUSINESS LICENSE NO LICENSE NO NO /t DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO -^ PUBLIC SEWER @ $3 OO 4 & ° 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 @ 51 SO ALTER REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2 OO 0 $ OWNERS PERMIT $ . _2 OO AUTHORIZATION TOTAL FEE £~ o^. 1 HACON-ING SIGN OWN OWN ADDF 1APPLAND STA11 AND BAD OWNEFm SIGN 0 VE AT THIS DATE A CONTRACT WITH THE HEREIN rRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD TO THE PUBLIC SEWER ED THIS DAY OF ER OR JESS — — • HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS .ICATION AND STATE THAT THE ABOVE IS CORRECT AGREE TO COMPLY WITH ALL CITY ORDINANCES AND 'E LAWS REGULATING PLUMBING AND SEWERS HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED /OR LICENSED AS REQUrfJEQ BY THE CITY OF CARLS AND STATE OF CALLPeffNIA/OR THAT 1 AM THE LEGAL ER OF THE ABerv^f/geSlZRIBED RESIDENTIAL PROP- ./Ff^^L BUILDING _.^. / ^> /^~* / ^, -. (/ ADDRESS /?3 / (£ ( l^J U IS) fl /f Oj^J LS7 NEAREST / CROSS ST t ' ^ OWNER /-^-^ ^^; ^//7 /h /</ /^4/r^r ADDRESS ?^<^ /' JT/,7/<r /X CITY ^ ^/ t*s/S £? J (-v/ TEL NO CONNECTION DATA Lateral Charge Computation 30HIOV ©4— A — Add Vert 0) 4 — A — Total Cnrntnirtinn Cntt 10 / Service Chargn , .. Total 1 fltsral Chargn Lat No Logged in Plat _ LINE COST DATA A D & Assmt Nn LINE COST CCS) / Hwllmg OTHFR TOTAI FOR SEWER LOCATION «" i>) St NORTH ENGINEERING SEWER DEPT Signed ^ignnrl TM£^Sewer Permit When Properly Filled Out Signed and Validated Issued By PERMIT VALIDATION