The URL can be used to link to this page

Home My WebLink About2623 GALICIA WAY; ; 77-1573; PermitA1D - MODEL NO. I S MAR 4169* I *307 50 BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 ADD//cant to como/ete numbered soaces on/v. Phone 729-1181 Permit No. T7 7/5"73 JOB ADDRESS 'ASSESSORS 'PARCEL NUMBER LEGAL loEsce. LOT NO. I g 7 OLK TRACT Ic &*i / (E5CE ATTACHED SHEET) I BOOK PAGE PAR. OWNER MAIL ADDRESS 2 cso / &- £/2 ZIP PHONE 75 ' -5 5117 7 CONTRACTOR MAIL ADDRESS PHONE STATE LIC. NO. CITY LIC. NO. Q S J"99 ARCHITECT DR DESIGNER MAIL ADDRESS 4 PHONE LICENSE NO. ENGINEER - MAIL ADDRESS PHONE LICENSE NO. CO P ATION INS. CARRI ER MAIL ADORES 7V 57Z USE OfRIJILDINC 51,F. D. RMS f NO(SJ 8 Class of work: 1NEW El ADDITION El ALTERATION El REPAIR El MOVE LI REMOVE 9 Describe work: 10 Change of use from Change of use to 11 Valuation of work: $ f5' 7 PLAN CHECK FEE $ PERMIT FEE S - D SPECIALCONDITIONS: Type of Const. /j,/ Occupancy Group MICO FILM FEE Size of Bldg. (Total) Sq. Ft No. of Stories Max. 0cc. Load Fire Zone Use / Zone H€..7' Fire Sprinklers Required Elves UQ. APPLICATION ACCEPTED BY DATE - I PLANS CHECKED BY APPROVEZ"OANCE BY No. of Dwelling Units 1 - OFFSTREET PARKING SPACES. No. No. Sq. Ft./_lOpen Covered _.1. NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB. ING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAVS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. . . - I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS' TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIDt'QR NOT THE GRANTING OF A PERMIT DOES NOT PRE 'L.GJVE AUTHORITY TO VIOLATE OR CANCEL THE PRO ION LOCAL LAW R ON UC I F OR ERFO NCE C"ATE) SpecialApprovals Required Received NotRequired PLANNINGDEPT. HEALTH DEPT. - FIREDEPT. SOIL REPORT OTHER(Specify) ENGINEERING DEPT. WATERDEPT. - - IC RE OF CONTRACTOR OR I ED SIGNATURE OF OWNER (IF OWNER BUILDER) - (DATE) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH - 3y - TOTAL FEES $ f 01 -. - ,fl .#4 'wt5'- - •'t - t - - V - .0 ", a ,,, .* , 44 MODEL NO BUILDING PERMIT APPLICATION City of CARLSBAD; CALIFORNIA 92008 Applicant to complete numbered spaces on/v. Phone 729-1181 Perm> Nn /)73 ) JOB ADDRESS 1 ASSESSöR"S' - PARCEL NUMBER LEGAL 1 OESCR. J LO T . NO ( B L P( I TRACT 4 , 4 I (!JSEE ATTACHED SHEET) BOOK PAGE PAR. / I ' / OWNER MAIL ADDRESS ZIP ' PHONE 2 7 : '- CONTRACTOR MAIL ADDRESS PHONE STATE LIC. NO. CITY LIC. NO. 0 • ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. 4 ENGINEER . MAIL ADDRESS PHONE LICENSE NO. 5 I" COMPENS TION INS. CARRIER IL ADDRESS.." 6 /1Qm;N BRAN C -Pi Q USE OF BUILDING ),/i ° NO. BORMS_f z'4 ------ BA 8 Class of work: IXEW LI ADDITION El ALTERATION 0 REPAIR 0 MOVE LI REMOI 4-11 A 9 Describe work: V ( 10 Change of use from Change of use to 11 Valuation of work: $ 4 / ' PLAN CHECK FEE S ' Ic,2 PERMIT FEE $ ' SPECIAL CONDITIONS: Type of 4/ Occupancy / .3' MICRO FILM FEE' Const. 7 Group Size of Bldg (Total) Sq. Ft. 1f,..Stories No. of ..2 Max. 0cc. Load ." Fire Zone Use Fire Sprinklers APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVEO"FOR ISSUANCE BY ) Zone Jt¼. , Required Elves DN'o No. of OFFSTREET PARKING SPACES: I DATE DATE Dwelling Units • No. A No. Covered ,,ar sq. Ft. ' 6.' Open NOTICE Special Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- PLANNING DEPT. ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- FIRE DEPT. TION 'AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- OTHER (Specify) MENCED. . I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER DEPT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREI"OR NOT, THE GRANTING OF A PERMIT 'DOES NOT PRESUME TQ._G.KVE AUTH,O,.RI.T..'yTO VIOLATE OR CANCEL THE PROVISIONS OF ANY'Q'T'HER STE\O'RLOCAL LAW R6GULATNG CONSTRUCTION OR TEPERFORNCE OI COSRJICTrØ. c 'SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEl SIGNATURE _OF_ OWNER _(IF _OWNER_BUILOER) (DATE) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION ck. M.O. CASH 'PERMIT VALIDATION CK ' M.O. CASH' TOTAL FEES 1i INSPECTOR I IU II JI El El 1.1.- - j 3 DATE .- REMARKS ,' ,. INSPECTOR?. - FOUNDATIONS: / SET BACK TRENCH REINFORCING FOUNDATION WALL &. WEATHER PROOFING CONCRETE SLAB.;. FRAMING - INT. LATHING OR DRYWALL . . EXT. LATHING MASONRY. - . ' - . • :1 •: . FINAL USE SPACE BELOW FOR NOTES FOLLOW UP ETC 33p-77 Fdn. forms and steel :O.K. B. 'Nelson 4-5-77' Páür: ;O.K. E. Plude 5-11-77 Sheathing 0 K B NElson 5-25-77 Frame Rough Plbq, rough elec Corrections B Nelson N 6-17-77 Insulation: O.K. Mer Rough.çlec;. O.K. •. 6-20-77 Frm 0 K Mr ........................... " -.. . ... ,. . . .. . • -- :-: . • . • - ... •:- - . . • . . •, -' • •: '",: .- . -': - I S r r . ELECTRICAL PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 - '? Aoø/icant to como/ete numbered soaces on/v. Phnn 7Q-11R1 JOB ADDRESS / /3 .iJa&c LEGAL LOT NO TBLK. rRAC T J ir (ESEE ATTACHEDSHEET) OWNER MAIL ADDRESS ZIP PHONE 2 L),?I 77 // is7-kp ., CONTRACTOR MAIL ADDRESS 3 LJ za2e, PHONE STATE LIC. NO'',fj CITY LIC. NO. ,_STATE SS? )dL.i&i ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO. 4 ENGINEER MAIL ADDRESS PHONE LICENSE NO. 5 COMPENSATION INS. CARRIER MAIL ADDRESS BRANCH a 6jtt fô7 t-LJ'/tj USE OF BUILDING 7 8 Class of work: f1EW 0 ADDITION 0 ALTERATION 0 REPAIR 9 Describe work: PERMIT. FEES SWIMMING POOL WIRING, No. Each Fee SPECIAL CONDITIONS: NO INCREASE IN SERVICE NEW CONSTRUCTION, FOR EACH AMPERES OF MAIN SERVICE, SWITCH, FUSE OR BREAKER APPLICATION ACCEPTED BY: PLANSCHECKEOBY. APPROVED FOR ISSUANCE BY: NEW SERVICE ON EXISTING BLDG. FOR EA. AMPERE OF INCREASE IN MAIN SERVICE, SWITCH, FUSE DATE NOTICE THIS'PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- OR BREAKER TION AUTHORIZED IS NOT COMMENCED WITHIN 120 OAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM REMODEL, ALTERATION, NO CHANGE MENCED. IN SERVICE, FOR EA. AMPERE OF I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS INCREASE APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING TEMP. SERVICE UP TO AND INCLUD- / 4411, CONSTRUCTION OR THE PERFORMANCE OF, CONSTRUCTION. ING 200 AMP. . , J TEMP. SERVICE OVER 200 AMP. PER 100 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) ISSUANCE FEE / ___________________________________________ TOTAL FEES . . 3 k' 75 SIGNATURE_OF_OWNER_IIV_OWNER_BUILDER) .. (DATE) WHEN PKUI'EMLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT -' PLAN CHECK VALIDATION CII. . M.O. i/ CASH' PERMIT VALIDATION CII. M.O. . CASH. INSPECTOR USE SPA CE, BELOW F OR FOLLOW-UP,ETC. / .NOTES, .*....., .. ............--.... ...- "s.. [4w._, 3-31-77 Power - B Nelson LZ.....rr. 4. .-• ... .tA .t....... .............. . 6-20-77Rough elec O.K. B Nelson - ) .. ., .... ........ . .......... -...,. . . . .., . . ............ if . ..,,, . . . . .. I ..- ..: .;.-. I:.. ... 'S '• PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only. Phone 7291181 Permit N o.V_~>~/'S' JOB ADOR ENS N 22 3 (17s 1t 14 [ 1~ j LOT NO. J BLA I TRACT OWNER MAIL ADDRESS 2 7~2/fl 't/O7 •3$ CTnw6 ZIP PHONE CONTRACTOR MAIL ADDRESS 3 -f..:, Cj PHONE STATE LIC. NO. 3-2602 CITY LIC. NO. 39,3 ARCHITECT OR DESIGNER MAIL ADDRESS 4 Ee PHONE LICENSE NO. ENGINEER MAIL ADDRESS 5 .. - PHONE LICENSE NO. COMPEN ATION rN./A)4RIER -rL ADDRESS 6 , . T>/(,,... BRANCH USE OF BUILDING 71' 8 Class of work: EJ.NW D ADDITION LJ ALTERATION EJ REPAIR 9 Describe work: PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: 3 WATER CLOSET (TOILET) BATHTUB 5 . /r, ,3,4'C LAVATORY (WASH B AS IN) - o SHOWER ilL KITCHEN SINK & DISP. lii? iil DISHWASHER APPLICATI.ONACCE ff PLANS CHECKED BY IAPPROVED FOSSUAN BY. J ),/ 7 DATE . LAUNDRY TRAY / CLOTHES WASHER 7 WATER HEATER NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS.OR IF CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. . I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S,. URINAL DRINKING FOUNTAIN FLOOR—SINK OR DRAIN - SLOP SINK / GAS SYSTEMS NO. OUTLETS__________ ) WATER PIPING & TREATING EQUIP. - - WASTE INTERCEPTOR - . VACUUM BREAKERS LAWN SPRINKLER SYSTEM - - SEWER NUMBER CLEANOUTS 0' CESSPOOL SEPTIC TANK & PIT ROOF DRAIN'S SIGNATURE or CONTRACTOR OR AUT,4ORIZED AGENT ) (DATE) - /tffv - 4 ISSUANCE FEE $ ' TOTAL FEES $_ 3' O SIGNATURE _OP_ OWNER _(IF _OWNER BUILDER) (DATE) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. • CASH INSPECTOR t.'iNSPECTI'ON REPORTS DATE ITEM REMARKS INSPECTOR .1 , ..•. -- - . ... - c.'.0,'4'., S - ... -. :- •. I. ...-- . .•'....5,. USESPACE BELOW FOR NOTES, FOLLOW-UP,,-ETC. -. 3-29-77 Sewer, Underground Plumb., and Underground Water - O B. Nelson. 6-20777 Rough 0 K Mer- - -S •- '55 - -. 'l -, 5-- -'S S • 5 5. - 1 .5 ............S S • -L.- S • S S -,, -S--u .. I - S • 5, 5 5 . S - • . 5 -- , - - ', . 5 S - - - .,.5 - :4_,,.- :_ - • - 55 :. • '-'I - ' 6 •i.? :ME.CHANICAL PERMIT APPLICATION City. of CARLSBAD CALIFORNIA 92008 ., Applicant to complete numbered spaces only Phone 729-1181 PermitNoZ 'i JOB ADDRESS L4 S LOT NO. . . BLK . .FRACT (ESEE ATTACHED SHEET), OWNER , MAIL ADDRESS ZIP .. PHONE 2./,t,77 . co ACTO . MAIL ADDRESS PHONE STATE LIC. NO. CITY LIC. NO.- to toJ/ ffi',c S. 577$ ARCHITECT OR DESIGNER MAIL ADDRESS PHONE - LICENSE NO. 4 .. . ç ENGINEER . MAIL ADDRESS .PIONE 4 LICENSE NO. 5 i .LCNOR. MAIL ADDRESS II' I/ \, \. ,_. BRANCH 6 ----. _-'- •e \. USE OF BUILDING -... 8 Class ofwork: 24w . U ADDITION El ALTERATION' U REPAIR 9 Describe work 17-LL I . Type of Fuel: Oil D Nat. Gas U LPG. U I . PERMIT FEES L-C SPECIAONDITIONS: . No. . . . . Type of Equipment Fee.. - . Air Cond. Units—H.P. Ea. . . $ Refrigeration Units—H.P. Ea. - Boilers—H.P. Ea. . Gas Fired A.C. Units—Tonnage Ea. Forced Air Systems—B.T.U. &WiJI40 Ea. APPLICATION ACCEPTED BY: PLANS CHECKED BY APPROVED FOR ISSUANCE BY: Gravity Systems—B.T.U. M Ea. :0, . Floor Furnaces—B.T.U. . 1.. __________________________________________________ Wall Heaters—B.T.U. . ' M. '. NOTICE Unit Heaters—B.T.U. M, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- Evaporative Coolers . TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF - Clothes Dryers CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- Ventilation Fan MENCED - - Hood ..- . - I HEREBY CERTIFY-THAT I HAVE READ AND EXAMINED THIS Range - APPLICATION AND-KNOW THE SAME TO BE TRUE AND CORRECT. Air Handling Unit— C.F.M. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 5 - TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED Incinerator HEREIN OR NOT, THE GRANTING OF A PERMIT DOES-NOT - PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING - - CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. %L SIGNATURE F CONTRACTOR OR JTHRIZED AGENT (DATE) . . .. . . .5_ ISSUANCE FEE $ SIGNATURE OF OWNER (IF OWNER BUILDER) . (DATE) . S . TOTAL FEES . -' : WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION crc.. M.O.- CASH PERMIT VALIDATION. CK.. MO. . CASH :.:-:- ••••• . • .. . . - INSPECTOR o 4.. / * A - ----_r_____-_--.- - OA too - __ rftZ __- r- ~?4;P4- 70P I! V it!4 We &_-__-- -- 11---H- I EPARTM I p,DRESS: INTEADEPARTENTAL INFORMATION SHEET %w RAW Tiai'Rl OF ••• • • CITY OF CARLSBAD - • - 1 • R,1;Iin n_..i_ DEPARTMENT ... LOT WIDTH_•. ZONE_____________ ( ITS PROVIDED ALLOWED _REQ PRKG SPACES PROVIDED %OF'COVERAGEYI( ALLOWED_7/4_BLDG. HEIGHT (i ALLOWED , _- 'I,, 1 / q MREAR FRONT SETBACK__ZOSIDE YARD YARD INTRUSIO 4 NS - /g11tfr- ENVIRONMENTAL PROTECTION REQ'TS._N/ LANDSCAPE PLAN_______________ . 4 - ADDITIONAL COMMENTS .: • -. U E PER MI i t2—DATE -//71OCC U PAN CY_____________ ENGINEERINGDEPARTMENT I.O.W._-_INDUSTRIAL WASTE________________________ cAJb CONNECTION_L MENTS_— SEWER JEWAY LOCATIONS_/cc ci- PERMIT EMENTS DRAINAGE_- 'AL DESCRIPTION_LL'T LA CWTk S cb-tfl.f - JJtTp,! /-f hO f/7 ADDITIONAL COMMENTSI ILk(l/4' • t. -•- •/ I SSjuJUJ1;1IIlr4d - FIRE DEPARTMENT - .• SPRINKLING SYSTEM • -. S *5- - • F E PROTECTION EQUIPMENT FIRE !ALARMS_ ExIT • - • - A- - -- - FIRE HYDRANTS_. LOCATION______________________________ /1ADDmONAL COMMENTS - i ... • .. • ., . ISSIJE1 PERMIT TE OCCUPANCY_ _DATE_________ ENT C,. ADDITIONAL COEN IUEPERMITff' T*TO*PLAINING - RN E TO -BLDG.'.,, CARLSB1 7OLIVENHAIN SAN MARCOS UPANCY__________ SENT TO ENG. DEPT. ....RETURNED TO, BLDG.., *-•-- . 'I- - .—DATE .,.4 -- -7 •,- • 4 BENTON ENGINEERING, INC. APPLIED 501L MECHANICS - FOUNDATIONS - 6717 CONVOY COURT 6N OIGO, CALIFORNIA 92111 11 1r7-7 PHILIP HNKINI3bNTON March Png(orsr clvii. gRGINg iviarcn 10, 17/I - Tai.ieuo,t (714) •65-1eb Mr. Thomas Elliott 2550 El Camino Del Norte Olivenhain, California 92024 R Subject: Project No. 77-3-9M Moisture Contents in MAR ?197 S Lot 97 ubgrade Soils CITY OFCI4RLSBA La Costa South Unit No. .1 Building Departme Carlsbad, California DeorMr, Elliott, This is to report the results of tests to determine the moisture contents of the soils- in the. upper. three feet below finished grade in the proposed building area at the subject site. The soil samples were obtained on March 15, 1977 and the results of the moisture eterrninatiors are presented as follows; . . . S Depth of Sample Moisture Boring Approximate Below Existing Content No, Location Grade in Feet % dry wt 1 Northerly Portion of 1.0 . 20.4. Proposed Building Area 2.0 16 8 . S 3.9 . :16.8 2 Southerly Portion of 1.0 31.7 Proposed Building Area 2,0 33.1 3,0 23,4 It Is concluded from the field observations of the various soil types, and the final results of the moisture determinations that the soils in the upper three feet below finished grade at the locatio sampled have been sufficiently moistened to minimize the potential expansion of the soils as recommended in our report under Prolect No 68-11-23D, dated June 23, 1?69. Respectfuljy submitted, BEN TON ENGINEERING, INC. By - R. C.Remqr Dist r: RCR/SHS/ew - 0 Reviewed by • • S. H. Shu; Civil Epgneer . R.ç.E. No. 1913 (2) Addressee -• (1) City of CarIbqd, Building Departm.nt Attentiori Me , Roy -Green. LEUCADIA COUNTY WATER DISTRICT ': " APPLICATION FOR SEWER SERVICE Owner's Name: DLB 77 . . Phone No. 756-3497 Mailing Address: 2550 El Camino Del Norte Olivenhain . •• 'Service Address: 2623 Galicia Way . . .. - •Trct Description: Lot .97 La Costa' South Unit #1 . •" . . " Type of Building - Single Family No Units Connection Charge $500_00 Lateral Size: 4" 6" 8" . Saddle: •. . . •. • . •, Extra footage: @ $ _. Easement Connection' . . . . Extra depth: @ $' S Lateral Charge •: Total .$500.00', Amount Rec'd $ $500.00 . How Paid ck#12 ' •". Date Paid 3/21/77 . " . . . '' Rec'd by* S.Deibert s •' The application 'must be signed by the owner (or his authorized representative) of the property to be served.' The total charges must be paid to the District at the time the application is submitted. ,, If a service lateral is required, it will be installed by the Leucadia County Water District. The service lateral is that part of. the sewer system that extends from the main collection line in the Street (or easement) to the point in the street (at or near the applicant's property line) where the service lateral is -connected -to-the applicant's building sewer. , The applicant 'is responsible for the construction,' at the applicant,s expense, of the sewer pipeline (building sewer) from the applicant's plumbing to the 'point in the street (or easement) where a connection is made to: the service lateral. The connection of the applicant's building sewer to the service lateral shall be made: by the applicant at his expense. The connection must be made in conformity- with the, District's specifications, rules and regulations; and IT MUST BE INSPECTED AND APPROVED BY THE' DISTRICT BEFORE THE SEWER SYSTEM MAY BE USED BY THE APPLICANT.. THE APPLICANT, OR ' HIS AUTHORIZED REPRESENTATIVE, MUST NOTIFY THE DISTRICT AT THE TIME INSPECTION IS DESIRED. ANY CONNECTION MADE TO THE' SERVICE LATERAL OR COLLECTION LINE WITHOUT' PRIOR APPROVAL AND INSPECTION BY THE DISTRICT WILL BE CONSIDERED INVALID AND WILL NOT, BE ACKNOWLEDGED. After connection is complete, 'the property described above is subject to a monthly sewer service' charge, billed bi-inonthly in advance. The rate will be governed by the use of the property, single family, multiple dwelling or commercial. Non-payment of. • the sewer service charge is subject to a, 5% penalty per month, plus disconnection if necessary. ,The undersigned hereby agrees that the above information given is correèt and agrees to, the conditions as stated: -3 VD0 ____ 642 Owner's Signature Date • ' Account No.