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HomeMy WebLinkAbout1574 BASSWOOD AVE; ; SE811741; Permit.- CONTRACTOR'S ADDRESS I* 4 4 &&'+ ,.) * A ~~~~~~~ .* * ', APPLICATION FOR PERMIT to CONNECT TO CITY R -~ ~ ~ ~~ ~ - CITY OF CARLWAD ENGINE ERIN G D EPA RTM EN1 438.5541 FOR APPLICANT TO FILL IN MAILING , ADDRESS - 1 NEW BUILDING I I' I EXISTING BUILDING I LEGAL DESCRIPTION LATERAL LOCATION ST. I ar LA~RAL NO. INSTALLATION DATE ISSUED BY e' DATE ISSUED VAL1 DATION ' P' . 9 J I /. . (/& f #ff / *2 I 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. @, F T. "b *+ ?.-v 2 OVER '10' V. -8 FT. ' i TOTAL CONSTRUCTION COST SERVICE CHARGE (REPAVING ETC. TOTAL LATERAL CHARGE ASSESSMENT OIST. Nd: FRONTAGE COST PER FT. TOTAL OTHER CONNECTION FEE NO. UNITS TOTAL PUMP STATION FEES NO. UNITS-COST PER UNIT TOTAL TOTAL CHARGES (LATERAL ETC.) 8 WHITE Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permitter -, .t rrriu, ~- . . " ,1_" ,.