HomeMy WebLinkAbout1574 BASSWOOD AVE; ; SE811741; Permit.-
CONTRACTOR'S ADDRESS
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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
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