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HomeMy WebLinkAbout1811 BASSWOOD AVE; ; SE647496; Permit. cFn'OF CAWBAD NO. - DING DEPARTMENT DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER 8 $3.00 IT SEPTIC TANK. SEEPAGE PIT OR FOR APPLICANT TO FILL IN iEGAL OESCRfPTlON LOT NO BLOCK TRACT USE OF BUI LDl NGS CONTRACTOR Andmsm 8C Robihrarat Cu8fa ADDRESS 25u A State S-e t CITY Carlabad, CUEL. NO. 729 2318 CONTRACTOR'S STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO. 208302 4785 0 $5.00 OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN.. SEWER OR DISPOSAL SYSTEM @ $2.00 OWNER'S 1 PERMIT 51 z51g I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- ING TO THE PUBLIC SEWER. AUTHORIZATION TOTAL FEE SIGNED THIS DAY OF OWNER OR OWNER'S AGENT ADDRESS I HEREBY ACKNOWLEDGE THAT I 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. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED SIGNATURE cKl Y. {///'~~~, +."'--- OF PERMITTEE - /e Y I, 7496 PERMIT - APPLICATION PAID I Jvn -4-64 ?r2872*******5.OO BU I LDl NG ADDRESS NEAREST CROSS ST OWNER tQarrdMachado MAIL ADDRESS ~~ood CONNECTION DATA r Lateral Charge Computation 30' H., IO' V. @ 4" = __ 6" - - __ Add. Horiz. @ 4" = __ 6" = - Add. Vert. @ 4" = - 6" = - Total Construction Cost 10% Service Charge Total Lateral Charge Lat. No.: Logged in Plat: LINE COST DATA A. D. & Assmt. No. LINE COST: C. C. @- / dwelling P. S. @- / dwelling OTHER TOTAL Grand Total, Lateral, etc. FOR SEWER LOCATION st. NORTH ENGINEERING SEWER DEPT. Signed I Signed This is LSeCr Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION NG DEPARTMENT PERMIT APPLICATION FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO BLOCK TRACT USE OF BUILDINGS : 4' ADDRESS CI TY TEL. NO. CONTRACTOR'S STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO. I OWNER'S AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- tNCI TO THE PUBLIC SEWER. SlCPPlkD THIS DAY OF OWNER OR OWNER'S AGENT . . --- I HEREBY ACKNOWLEDGE THAT I HAVE READ THF APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- 5An AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- ERTY. SIGNATURE OF PERMITTEE MAIL ADDRESS TEL. NO. CITY CONNECTION DATA Lateral Charge Computation 30' H., IO' V. @ 4" = __ 6" = - Add. Horiz. @ 4" = ___ 6" = - @ 4" = __ 6" = __ Add. Vert. //5< 0 0 Total Construction Cost //5#00 lOyo Service Charge //.50 Total Lateral Charge & Logged in Plat: MAP 27~64 ILat. No.: LINE COST DATA C. C. d! / dwelling so ~00 MOMf OTHER n/sh/lF P. S. @- / dwelling TOTAL Grand Total, Lateral, etc. 55/ FOR SEWER LOCATION $1 st. NORTH ENGINEERING SEWER DEPT. Signed _____-___ 1 Signed This is a Sewer Permit When Proper1 Issued By PERMIT VALIDATION