HomeMy WebLinkAbout260 Olive Ave; ; SE680513; PermitCITY OF CAIWBV
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL DESCRIPTION LOT NO.
BLOCK TRACT
USE OF BU<LD<s;;
CON~!<_/
ADD
CITY TEL. NO.
CONTRACTOR'S STATE
LICENSEJO-,,___,,
C ARLSBAD BUSINESS
LICENSE NO.
<
NQ. DESCRIPTION OF WORK FEE
'I-HOUSE SEWER CONNECTING TO
PUBLIC SEWER • $3.00 ;/) ' w
~ SEPTIC TANK. SEEPAGE PIT OR
~TS 0 $!5.00 , OVERFLOW SEEPAGE PIT, DRAINF IE.LD EXTN.,
CESSPOOL. DRYWELL. MANHOLE O $!5.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 0 $1.150
CONNECT ADDITIONAL B LDG. OR
WORK TO HOUSE SEWER • $1.!50
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM 0 $2.00
• s
OWNER'S PERMIT s 2 00
AUTHORIZATION ~ ·--
TOTAL FIEE ic:,c,
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONT RACTOR TO CONNECT THE ABOVE DESCRIBED BUILD·
ING TO THE PUBLIC SEWER.
S IGNED THIS -----DAY OF ---------OWNER OR OWNER'S AGENT----------------
ADDRESS
SEWER
PERMIT • APPLICATION
Sr .. 10 OCT-t.i-68 -cc3122******Y:>.UU
BUILDING
ADDRESS
NEAREST
CROSS ST.
OWNER
MAIL
ADDRESS
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation
30' H., 10' Y. @ 4" = __ b"=--
Add. Horiz. @ 4" = __ b"=--
Add. Vert. @ 4" __ b"=--
Tot11I Construction Cost
I 0% Service Ch11rge
Tot11I L11ter11I Ch11rge ____ _
lot. No.: Logged in Pl11t:
LINE COST DATA
A. D. & Assmt. No. _______________ _
LINE COST: ----------------r-,,,-______ ,?a, &_2
Gr11nd Tot11I, Loterol, etc.
FOR SEWER LOCATION
~-----------------1~
St. NORTH
ENGINEERING SEWER DEPT.
Signed _______ _ Signed ________ _
Properly RIied Out, Signed end Validated
luued By __________________ _
PERMIT VALIDATION