HomeMy WebLinkAbout231 NORMANDY LN; ; SE728219; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK
USE OF
BUILDINGS
CONTRACTOR
ADDRESS
CITY
TRACT (•
TEL. NO.
.. ..
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ $3.00
SEPTIC TANK, SEEPAGE PIT OR PITS @ $15.00
OVERFLOW SEEPAGE PIT, ORA.INFIELD EXTN.,
CESSPOOL., DRYWEL.L, MANHOL.E @ $!5.00
HOUSE SEWER CONNECTING TO PRIVATE D I SPOSAL SYSTEM @ $1.!50
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER @ $1.!50
ALTER. REPAIR OR ABANDON HOUSE
SEW ER OR DISPOSAL SYSTEM @ $2.00
@ s
OWNER'S
AUTHORIZATION
I PERMIT
TOTAL FEE
s 2 00
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD,
ING TO THE PUBLIC SEWER.
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 A GREE TO COMPLY WITH A LL C ITY 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-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP.
ERTY.
SIGNATURE
OF PERMITTEE -----------------
SEWER
PERMIT. APPLICATION
BUILD ING
ADDRESS
NEAREST
CROSS ST.
OWNER / t
MAIL
ADDRESS
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V.
Add. Horiz.
Add. Vert.
@ 4" =
@ 4" =
@ 4" =
---6" = ---------
---6" = ---------
___ 6" ----------
Total Construction Cost ____ _
I 0% Service Charge
Total Lateral Charge ____ _
Lot. 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
~1-----------------1~
St.
ENGINEERING SEWER DEPT.
NORTH
Signed ________ _ I Signed _______ _
This is • Sewer Permit When Properly Filled Out, Signed and Validated
Issued By __________________ _
PERMIT VALIDATION