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HomeMy WebLinkAbout2739 STATE ST; ; SE1971; PermitCITY OF CARLSBAD BUILDING DEPARTMENT '- 7C) PERMIT - APPLICATION FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. BLOCK *\, £..•!*-,? .'V / <i~- «,#4/y fft&CT *""";* :-• £t ' / /. £• USE OF .... , - ,BUILDINGS :,- .>'-itf L.t~ /<• >t/ -' .'• '-•'-;.„ •: - - -' CONTRACTOR //V ~ /_ >" •;- .</ •'';-•-,. " -' ADDRESS CITY CONTRACTOR'S STATE LICENSE NO. NO. DESCRIPTION OF TEL. NO. CARLSBAD BUSINESS LICENSE NO. WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.0O SEPTIC TANK, SEEPAGE PIT ORPITS @ S5.OO OVERFLOW SEEPAGE PIT. DRALNF1ELD EXTN., CESSPOOL, DRYWELL. MANHOLE @ $5.OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.5O CONNECT ADDITIONAL BLDG. OR ALTER. REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ S2.OO @ s OWNER'S AUTHORIZATION I HAVE AT THIS DATE A CONTRACTOR TO CONNEC ING TO THE PUBLIC SEW SIGNED THIS ADDRESS TOTAL FEE 2 OO CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD- ER. DAY OF I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- ERTY. SIGNATURE P4. 3-* -7/ * ^3^ .^ 7 ri9 ^>^ r-^ -z?' NEAREST CROSS ST. - - OWNER ^.--r"- .'—' • f. , ' '.S fi:s'-''~ CT-{ .r ' MAILADDRESS --,... CITY TEL. NO. CONNECTION DATA Lateral Charge Computation j" :,- r ''T* . / , ,r. ••- ! '•• . • fl-J '- 30' H.. 10' V. O 4" —. k» — Add. Vert. © 4" — h" — f f I00/. Serv ce Chargs \ Lat. No-: _ _ Logged In Plat: LINE COST DATA A. D. & Assmt. No LINE COST: £* / C r* (7$\ - ' - " / j tr* j- -•- '' " ' >i f *-^t-f. L,. ltf_^_ / Hwfillinr] P. S. © / r^lllnr, OTHER TOTAI f&& Grflnrl Total, Lfltorfll, ntr. FOR SEWER LOCATION v ^ St. NORTH ENGINEERING ..= SEWER DEPT SiqnnH _&=- --'.-• -e f '•'"'- '- ^r,f>A Thit is a Sewer Permit When Properly Filled Out, Signed and Validated Issued By PERMIT VALIDATION aj.^.- • C ? . J ...*-.-