HomeMy WebLinkAbout1391 OAK AVE; ; SE781991; PermitAPPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
729-1181 EXT. 35
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS
)
EXISTING BUILDING
)
LATERAL LOCATION
ST.
LATERAL NO. _______ INSTALLATION DATE--------11
BUILDING DEPT.
ISSUED BY ------------------
DATE ISSUED-...L..7_-=-=-----<------------
VALIDATION
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10') ________ _
OVER 30' H. ___ @.,.__ ___ FT. _________ _
OVER10'V. @ FT. _________ _
STANDARD 6" (Max. H. 30', V. 10') _________ _
OVER 30' H. ___ @. ___ FT,----------
OVER 10' V. @ FT,----------
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC,) ________ _
TOTAL LATERAL CHARGE-~--------''---
LINE COST DATA
ASSESSMENT DIST. NQ._....._ ___________ _
FRONTAGE COST PER FT. ___ TOTAL __ _
OTHER--------------------
CONNECTION FEE
NO. UNITS ___ COST PER UNIT---TOTAL---
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ____ TOTAL---
TOTAL CHARGES (LATERAL ETC.) ___ 2.._9 __ 7 __ 0_" __