HomeMy WebLinkAbout1335 BASSWOOD AVE; ; SE751353; Permit,s rY-4
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD
ENGtNEERtNG DEPARTMENT
729-1 181 EXT. 35
-OR APPLICANT TO FILL IN
MAILING ADDRESS , 1
{ 1! 8 '\b.j ut.__
CONTRACTOR
CONTRACTOR'S ADDRESS
I
NEW BUILDING E LEGAL DESCRIPTION
1 EXISTING BUILDING I
I LATERAL LOCATION
t
I
. .. I I I I ST. 1
LATERAL NO. INSTALLATION DATE
N? SE 1858 1 BUILDING D€PT.
- DATE ISSUED -~
VAL I OAT1 ON
LATERACCHARGE COMPUTATEN-
STANDARD 4" (Max. H. 30', V. 10'
OVER30". @r FT.
OVER10'V. @ FT.
STANDARD 6" (Max. H. 30'. V. 10')
OVER 30' H. @ F T.
OVER 1O'V. -@ F T.
TOTAL CONSTRUCTION COST
SERVICE CHARGE (REPAVING ETC.)
TOTAL LATERAL CHARGE
I
ASSESSMENT DIST. NO.
FRONTAGE COST PER FT. TOTAL
OTHER
CONNECTION FEE
PUMP STATION FEES
NO. UNITS-COST PER UNIT-TOTAL '
IT 1, *I, TOTAL CHARGES (LATERAL ETC.)