HomeMy WebLinkAbout257 JUNIPER AVE; ; SW668936; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK
USE OF BUILDINGS
CONTRACTOR
CONTRACTOR'S STATE CARLSBAD BUSINESS
LICENSE NO. LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ::, Al,:>) PUBLIC SEWER • $3.00
SEPTIC TANK. SEEPAGE PIT OR
PITS 0 $!1.00
OVERFLOW SEEPAGE PIT, ORAINFIELD EXTN.,
CESSPOOL, ORYWELL, MANHOLE • $!5.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1.!50
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER • $1.!S0
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM O $2.00
• $
OWNER'S PERMIT • 2 00
AUTHORIZATION
__ .... I TOTAL l"EE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-
ING TO THE P.UBLIC 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 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-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP.
ERTY.
SIG;}f TPUE~~ ITTEE _..S~~~~==-~C.:::::1q<~~~~,::::::==--
SEWER
PERMIT • APPLICATION
AQ'l • 31-66 ~"~:03128*******5.C0
CONNECTION DATA
Lateral Charge Computation
30" H., 10' V. @ -4" = ___ b" ----
Add. Horiz. @ -4" = ___ b" ----
Add. Vert. @ -4" = ___ 6" = ---
Totol Construction Cost
10% Service Charge
L11t. No.:
Totol loterol Chorge --.&----
l o ed in Plot:
LINE COST DATA
A. D. & Assmt. No. -------------.-----1 LINE COST: -f1
C. C. @_l_ I dwelling ~.P -+---
P. S. @ __ / dwelling ----------+---
OTHER-----------------'----
TOTAL
Grond Totol, Loterol, etc.
FOR SEWER LOCATION
St.
ENGINEERING SEWER DEPT.
I
NORTH
Signed ---------Signed ________ _
This Is a Sawer Permit When Properly Filled Out, Signed and Validated
Issued By __________________ _
PERMIT VALIDATION