HomeMy WebLinkAbout1432 BASSWOOD AVE; ; SE680206; PermitOESCRIPTION LOT NO.
19- TRACT LJM OF
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I HAVE AT THIS QATP A COEFtLlACT WITH THE HEREIN
ING TO fnE PUBUC SEWER. CONTRACTdR "0 OONNEm "HE ABOVE DESCRIBED BUILD-
SlONSD "4418 DAY OF OWNER OR OWNER'S AQBM
AWR658
I HEREBY AC'kNWLEWE THAT' I HAM READ THIS APPLlCATtON AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND SfATE, LAWS REGULA'F'tNO PLUMBING AND SEWERS. 1 HEReBY CWW'tfY THAT I &M PROPERLY REGISTERED AND/OR LlCD48eD A5 RCWMED BY THE CITY OF CARLS- BAD AND STATE OF CALlFdRNlA OR THAT I AM THE LEGAL OWNER OF THE ABQVg DESCRIBED RESlDENTIAL PROF ERTY. SIONATURB OF PERMITTEE
-.I LR
PERMIT - APPLICATION
CONN~ON DATA Lateral Charge Computation
30 H., IO' V. @ 4" = - b" = -
Add. Horiz. @ 4" = - 6" = -
Add. Vert.
onstroction Cost
10% Servi
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
/i
st. NORTH
ENGINEERING SEWER DEPT.
Signed I Signed
'fbh is 0 Swer Permit When Properly Filled Out Signed and Validated
lrswd By
PERMIT VALIDATION