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HomeMy WebLinkAbout2165 CHESTNUT AVE; ; SE1969; PermitGM^ARLSiD j ^&r SEWER j BOlEDlW;- DEPARTMENT e£&<-~ PERMIT - APPLICATION 1"' f *J **- ••''•' S•:- $*t>-^ •:; -.^T,, " ,..„-. ,6UI,^ FOR APPLICANT TO FILL IN LEGAL , .DESCRIPTION LOP NO. BLOCK f (JC» "^) - • .:,-' '>. -W '^*" TRACT! :'*,,., ft {, , t ff.Qtttjf-A USE OF BUIllDirsIGS V CONTRACTOR P . i> J i4^ l...t_. ADDRESS . ' CITY CONTRACTOR'S STATE LICENSE NO NO DESCRIPTION OF TEL. NO. CARLSBAD BUSINESS LICENSE NO. WORK FEE HOUSE SEWER CONNECTING TO ^ PUBLIC SEWER @ $3.00 ^i ••— . SEPTIC TANK SEEPAGE PIT OR PITS @ $5.OO OVERFLOW SEEPAGE PIT, DRA1NFIELD EXTN., CESSPOOL DRYWELL. .MANHOLE @ $5.OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $I.5O CONNECT ADDITIONAL BLDG. OR ALTER REPAIR OR ABANDON HOUSE : : SEWER OR DISPOSAL SYSTEM @ S2.OO : @ $ ; ' ; 'OWNER'S AUTHORIZATION • 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW OWNER OR ADDR"ESS PERMIT $ 1 2 ! OO '•' J— ' CONTRACt WITH , THE HEREIN T THE ABOVE DESCRIBED BUILD- \ ER. DAY -OF »V-*HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APF3tB£ATsfc>N AND STATE THAT THE ABOVE IS CORRECT A'NBKGlfEEtTO COMPLY WITH ALL'CITY ORDINANCES AND -ST^jgElllfwS REGULATING PLUMBING AND SEWERS ** %jMSt'B='fc*CERT1FY THAT 1 AM PROPERLY REGISTERED AJPSalBiiftgBftSED AS REQUIRED BY THE 'CITY OF CARL'S- BR^S^ptATE OF CALIFORNIA OR TH'AT.I AM THE LEGAL O^^p^^fe^THE AB.qy.Ej^DE-SCRI BED RES^IDENHri AL PROP- s i^^S^^s""" " y[jjfv'-^SS?S^S^«^ ." "" * '»< -<"*Vji i« j£^'f *Z£- ^V^*^-» "-^? jr — ' - """^ s-' ^ *= ' ~ ^ • .'.-..;.'"'' K ^ " ^ \ ADDRESS 3mtt'^ (~ ffr'^jf" t\ ( f NEAREST" " - CROSS ST. ?rtf.-lt~.: V t"> OWNER -JJ . f~J f ift f-l f "^ x^» MAIL ADDRESS .• • MiteCITY TEL NO t , ; CONNECTION DATA - '^ Lateral Charge Computation * 30' H., 10' V. © 4" — k" — //jf*» Add. Vert. & 4" — h" — Total Con^trurtion C<~><:t 10% Service Charge ff^tmt"*^ Tnt,| |^n| rh^/^4-^^1 Lat. No,: Logged in Plat * £* LINE COST DATA V.J A. D. X Assm+. Nn. « , -4-»^ C C (0) / / rWllin .<«^ "** ^O^B P. S. © / dwfillmg ,': ,« K, OTHFR Fr>:-- K*»r ' J itfNttf TOTAI /JrtjT1**! FOR SEWER 1OCATION ; •t/> ^ St. . , : NORTH ENGINEERING. ' SEWER DEPT. •Sig-nnH < -: Try visi-C,, : ... : ^[gnPrJ This is a Sewer Permit When Properly .Filled Out, Signed and Validated 'Issiidfl By Z4^ : % I • S ^" ^-. t> ^*- **-^ ^ *» " 5 ^/j. ^~v(- F. I i » 4