HomeMy WebLinkAbout1415 CHESTNUT AVE; ; SE680259; PermitCITY OF CARLSBA%
BUILDING DEPARTMENT^^
SEWER
PERMIT - APPLICATION
UAYE8-68 5^5715**** ***!>.OU
FOR APPLICANT TO FILL IN
CITY TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
NO.DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @
SEPTIC TANK, SEEPAGE PIT OR
PITS @
$3.00
$5.00
OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN.,
CESSPOOL. DRYWEUU, MANHOLE @ $S.OO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER @
JI.5O
$1.5O
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM @ $2.OO
@ $
OWNER'S PERMIT 9
AUTHORIZATION TOTAl_ FEE
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2
-JH
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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 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 I AMT'ROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED/BY THE CITY OF CARLS-
BAD AND STATE OF CALIFORNIA^CR THAT I AM THE LEGAL
OWNER OF THE A£P_VE DESCRIBED RESIDENTIAL PROP-ERTY.
SIGNATURE
OF PERMIT
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V.
Add. Horiz.
Add. Vert.
10% Service Charge
Lat. No.:
Total Construction Cost
Total Lateral Charge
Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.
LINE COSTS, €*3 '_
C. C. @—OC-y dwelling
P. S. @ / dwelling -
OTHER
_
"240.0C
# 5O *<X.
TOTAI
Grand Total, Lateral, fitr*
FOR SEWER LOCATION
JSigned
D
0
^•^TMsfc a Sewer Permit WJifnProperly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION