HomeMy WebLinkAbout1110 CAPE AIRE LN; ; SE680269; PermitCITY Of CAftLSMD
BUILDING DEPARTMENT
SEWBt
PERMIT. APPLICATION
FOR APPLICANT TO FILL IN
AUG 29-68 !TT2T83******50.00
LEGAL.
DESCRIPTION LOT NO.
BLOCK
USE OF
BUILDINGS
CONTRACTOF
BUILDING
ADDRESS
ADDRESS
CITY 'EL. NO.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
NO.DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER 41
SEPTIC TANK, SEEPAGE PIT OR
PITS 9
OVERFLOW SEEPAGE PIT, DRAINPiELD
CESSPOOL. DRYWELL. MANHOLE 9
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 9
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER 9
,$3.00
$9.OO
EXTN.,
$9.00
$1.90
$1.90
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM 9 $2.OO
9 *
OWNER'S PERMIT
AUTHORIZATION ^^^ FEE *
3
2
&2
oo
OO
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-
ING TO THE PUBLIC SEWER.
SIGNED THIS
OWNER OR
OWNER'S AGENT .
ADDRESS
DAY OF
I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION AND STATE THAT THE ABOVE IS 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 OF CARLS-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP-
ERTY.
SIGNATUREOF PERMITTEE
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V.
Add. Horiz.
Add. Vert.
10% Service Charge
lat. No.:
Total Construction Cost
Total Lateral Charge
Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.
LINE CC
C. C. @SO. / dwelling
P. S. @ / dwelling _
OTHER
.00
TOTAL
Grand Total, Lateral, etc.00
FOR SEWER LOCATION
Signed
This h a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION
M/