Loading...
HomeMy WebLinkAbout2625 CARLSBAD BLVD; ; SE647683; PermitD6*ARTMENT SEWER PERMIT - APPLICATION 7683 OCT-7-6M 5 955*******M.OO FOR APPLICANT TO fILL IN LEGAL DESCRIPTION LOT NO. BLOCK >-v USE OF / J BUlUJtNOS /W'-**- CONTF1ACTOR *£^t^L~Jt ADDRESS^ ^ CITY Cf&^^T^U^A CONTRACTOR'S STATE LICENSE NO, S\ TRACT ¥'-? • -, --O^ '- '^ '£. £L*Ji/'JLfZ%'t*-ls£t* A \.> TEL, NO. CARLSBAD BUSINESS LICENSE NO. NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TOPUSLIC SEWER 9 * 3. 00 SEPTIC TANK, SEEPAGE PIT OR PITS * »5.OO OVERFLOW 6KPAOE PIT, DRAIN FIELD EXTN., CESSPOOL, DRYWCLL. MANHOLE * SB.OO HOUSE SEWER CONNECTING TO PRtVATfc DISPOSAL SYSTEM 6 $1.5O CONNECT ADDITIONAL BLDG. OR i ALTER, REPAIR OR ABANDON HOUSE / SEWER OR DISPOSAL SYSTEM 9 S2.OO « * OWNER'S AUTHORIZATION 1 HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW OWNER OR ADDRESS — PERMIT f TOTAL FEE #£ D 2 OO ^ £0 CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD- ER. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. 1 -HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALWMWIA OR THA*b*M_/HE LEGALOWNER OF TH>-*P%^Pfi^^ED>tfB^EM!riAL PROP- ^^I&.™/S^£5 ^tt&jfae^F- BUILDING »-^ - — /7 f . / / S~i ADDRESS j^ t> «»ij t stf.'f-£4}V-&e>/ NEARESTCROSS ST. OWNER / ^^-fx-i-i^t, -f * M/l'f*~tt''' "" /'" ADDRESS ?2 &, ^^"^^^^T't'^^r CITY (JC^4,.(j$ C/*&.*f*^ TEL. NO. CONNECTION DATA Lateral Charge Computation 3n' H , i n1 v 191 4" — y — Ad^. V«ri-. © 4" — ft" — Uat. No.: Logged in Plat: LINE COST DATA A. ft. A A«mt, MA L1NF COST. C. r. <® / ^filimrj P. .^. O / rtwallinr, OTHFR TOT A! FOR SEWER LOCATION <S> t/J St. NORTH ENGINEERING SEWER DEPT. Sinn«r) - | ^Iqnari ThU is « S«wer Permit When Properly RHad Out, Slgn»d and Validated ffttnd 8y .— PERMIT VALIDATION