HomeMy WebLinkAbout151 TAMARACK AVE; ; SE669142; PermitCITY OF CARLSBAD
I BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK TRACT
CONTRACTOR
ADDRESS
CITY TEL. NO.
CONTRACTOR"& STATE
LICENSE NO.
CARLSBAD BU81Nl!S8
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER 0 S3.00 _:!:
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 Sl5.00
OVERFLOW SEEPAGE PIT. DRAINPIIELD EXTN.,
CESSPOOL. DRYWELL, MANHOLIE O 115.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 0 S 1.150
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER • Sl.!10
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM O SZ.00
• •
OWNER'S I PERMIT • 2
AUTHORIZATION TOTAL ll"EE ..s-
1 ..... ,.. ,., -
00
~
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD,
ING TO THE PUBLIC SEWER.
SIGNED THIS-----DAY OF ---------OWNER OR
OWNER"S AGENT----------------
ADDRESS
SEWER
PERMIT • APPLICATION
SPAID
MAR 11·66 -cc1715*******5.00
CONNECTION DATA
La .. ral Charge Computation
30' H., 10' V. @ 4" = __ 6" = _____ _
Add. Horiz.
Add. Vert.
@ 4" = --6" = -------
@ 4" = --6" = -------
Total Construction Cost ____ _
10% Service Charge
Total Lateral Charge ____ _
Lat. No.: l ogged in Plat:
LINE COST DATA
A. D. & Assmt. No. ----------------
LINE COST: ________________ _
C. C. @ __ / dwelling ____________ _
P. S. @ __ / dwelling ____________ _
OTHER __________________ _
TOTAL
Grand Total, lateral, etc.
FOR SEWER LOCATION
St.
ENGINEERING SEWER DEPT.
NORTH
Signed ________ _ Signed ________ _
This ls a Sewer Permit When Properly FIiied Out, Signed and VaUda .. d
lsaued By -----------------
PERMIT VALIDATION
CITY Of CARLSBAD
BUILDING DEPARTMENT
LEGAL DESCRIPTION
BLOCK
USE OF
BUILDINGS
CONTRACTOR
ADDRESS
CITY
FOR APPLICANT TO FILL IN
LOT NO.
TRACT
TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER 0 S3.00
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 115.00
OVERFLOW SEEPAGE PIT, DRAINP'l&LD EXTN.,
CESSPOOL, DRYWELL, MANHOLE O SIS.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 0 II.ISO
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER O $1.150
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM 0 $2.00
• •
OWNER'S PERMIT • 2
AUTHORIZATION I TOTAL P'IEIE
00
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-ING TO THE PUBLIC SEWER.
SIGNED THIS -----DAY OF ---------OWNER OR
OWNER'S AGENT----------------
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE RElAD THIS
APPLICATION AND STATE THAT THE ABOVE 18 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 OP' CARLS-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP.
ERTY.
SIGNATURE
OF PERMITTEE ----------------
BUILDING ADDRESS
NEAREST
CROSS ST.
CITY
SEWER
PERMIT • APPLICATION
•••••
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V. @ 4" = __ 6" = __ /p}.6
Add. Horiz. @ -4" = __ 6" = ______ _
Add. Vert. @ '4" = --6" = -------
10% Service Charge
Let. No.:
Tote! Construction Cost ____ _
Total Lateral Charge /;i..,b £12
Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.----------------
LINE COST: _______________ _
C. C. @ __ / dwelling _______ _
P. S. @ __ / dwelling ---------_____ _
OTHER ---------------....,...----.,...Jo. 06 TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
~1----------------1~
St.
ENGINEERING SEWER DEPT.
NORTH
Signed _______ _ Signed ________ _
This Is • Sewer Permit When Properly FIiied Out, Signed and Velldated
l11ued By -------------------
PERMIT VALIDATION
6.50