HomeMy WebLinkAbout167 REDWOOD AVE; ; SE1971; PermitOTY Of CAfilSB%
BUILDING DEPARTMENT
•• -
PERMIT - APPLICATION
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION
CITY TEL NO
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO
NO.
..
..
DESCRJPtlON OF WORK FEE
HOUSE .SEWER CONNECTING TO
SEPTIC 'YANK." SEEPAGE PIT ORPITS; 9 »B.OO
OVERFLOW SE'EPAO£ PIT PRAINFIELD EXTN .CESSPOOL, DRYWELL, MANHOLE 9 93 OO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 9 $1 SO
CONNECT ADDITIONAL' SLDG OR
WORK TO HOUSE SEWER 9 $1 SO
ALTER, REPAIR OR ABANDON HOUSE
SEWER- OR DISPOSAL SYSTEM 9 $2 OO
AuTHORlZATfQN
e *
PERMIT 9
TOTAL FEE
2 OO
I HAVB fit THJS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD
ING TO .^THft.PUBLIC SEWER
OWNER OR;
OWNER'S AGENT.
ADDRESS,,.
r HEREBYAPPLICATIONAND A5R1STATE L*
. DAY OF.
AND/OR
BAD AND
OWNER OF
ERTY
SIGNATUREOF PERMITTEE
, THAT i HAVE READ THISAT£ THAT THE ABOVE js CORRECT* WITH ALL CITY ORDINANCES AND
IHG .PLUMBING AND SEWERS.
THAT t AM PROPERLY REGISTERED
REOUIAED BY THE CITY OF CARLS-OF CALIFORNIA OR THAT i AM THE LEGAL
E -ABQVE DESCRIBED RESIDENTIAL PROP*
"' '
CONNECTION DATA
Lateral Charge Computation ' " "•
,30' H., 10' V.
Add Horn,
Add -Vert
LINE COST DATA
A D, & Assmt No
LINE (
C C.
P S @ /
OTHER ,
Grand Total, taterai etci*
FOR SEWER LOCATION
this 'n a Sewer Permit When Properly Filled Out, Signed and Validated
Issued' By
PERMIT VALIDATION