Loading...
HomeMy WebLinkAbout1674 CHESTNUT AVE; ; SE646087; PermitCITY OF CARLSBAD BUILDING DEPARTMENT ,5-6087 SEWER PERMIT - APPLICATION -PAID JAi-1 31-5'i 5TT2659*******5.00 FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. BLOCK TRACT USE OF BUILDINGS CONTRACTOR ££sza-~*J-*~^ £*~ j_t/S*~ CJiLStJjb^ i-*- 1 ADDRESS %L£.P/ _SxC*-4fe. \j£~ Is kciTY ^MJUs/ TEL. NO. 7 2-?- W/ W CONTRACTOR'S STATE 1 LICENSE NO. NO. DESCRIPTION OF CARLSBAD BUSINESS LICENSE NO. WORK FEE •Y HOUSE SEWER CONNECTING TO ^-, nft /• PUBLIC SEWER @ S3.OO '• SEPTIC TANK, SEEPAGE PIT OR PITS @ S5.OO OVERFLOW SEEPAGE PIT, DRA1NFIELD EXTN., CESSPOOL, DRYWELL, MANHOLE @ SS.OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.5O CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER @ $1 5O ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ S2.OO @ 9 OWNER'S 1 AUTHORIZATION 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW SIGNED THIS OWNER OR ADDRESS PERMIT $ 2 OO TOTAL FEE ^7* & $ CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD- ER. DAY OF 1 HEREBY ACKNOWLEDGE THAT 1 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 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF .CARLS- BAD AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- SIGNATURE &t*05*s~&\ kl/ntn^ — ' ^^__^_^^___ BUILDING J/ — . fj ,-? t? ~t-~ jH1 ADDRESS /& ^/ T &{* JUl/Uu^X^* NEAREST i , fjff CROSS ST. //('AJ&C-CY OWNER /2«-^^A^^_ V MAIL ADDRESS CITY TEL. NO. CONNECTION DATA Lateral Charge Computation _. /, , -rfSX<' .-'• ''\:~, . in1 H, in1 v @ 4" — h" — / AAA Hnri? (5) 4" — 6" — *^ AdH. Vert. (0> 4" — A" — « Tot«l Construction Cost , _ 10% Servir.B Chargn * Total Lateral Charrjo , , *s Lat. No.: , , Logged in Plat: LINE COST DATA A. D. & Assmt. No i INF COST: 3<,i8 X*4 137.52 c. c. © so / ^««iim0 5(0. ap P. S. @ / HwflllJng OTHFR _ p- , <• -, . . . TOTAI \ 87.52, |*£. l.-fe'A Grand Total, lateral, otr. 1^5 f'^3 &• FOR SEWER LOCATION "> l/> St. NORTH ENGINEERING SEWER DEPT. 5iignfirl ^i^nfirl This is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION