HomeMy WebLinkAbout1261 OAK AVE; ; SE646263; Permit' CITY Of CARUBAD
BUILDING DEPARTMENT
LEGAL
DESCRIPTION
BLOCK
USE OF
BUILDINGS
FOR APPLICANT TO FILL IN
LOT NO. ,-'oA. I~
CONTRACTOR~~~
ADDRESS I I
c1TY &eL~hA d TEL. No.
CONTRACTOR'S STATE
LICENSE NO.
CARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER O $3.00
SEPTIC TANK, SEEPAGE PIT OR
PITS O $1S.OO
OVERl"LOW SEEPAGE PIT, DRAINl"IELD EXTN ..
CESSPOOL, DRYWELL, MANHOLE O $15.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM O $1.150
CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER O $1.ISO
ALTER, REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM O $2.00
• •
OWNER'S
AUTHORIZATION
I PERMIT S 2 00
TOTAL FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD·
'sG ro THE PUBLIC SEWER.
SIGNED THIS -----DAY OF ---------OWNER OR
OWNER'S AGENT----------------
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT
ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND
STATE LAWS REGULATING PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
ANO/OR LICENSED AS REQUIRED BY THE CITY OF CARLS.
BAO AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RES
0
l,1DENTIAL PROP.
ERTY. J_ SIGNATURE ~J< _M ,t/, _ _ ,._ OF PERM ITTEE, • _ • _ • 1
This is • Sewer Permit When
Issued
SEWa
PERMIT • APPLICATION
PAID
APR -6·64* cc3021 **** * 225.50
NEAREST 1 / ., // CROSS ST. ,..,../(.yfc;UD D~.
OWNER H,s. . R
MAIL
ADDRESS
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation ~
30' H., 10' V. @ 4" = __ b" = __
Add. Horiz.
Add. Vert.
@ 4" = __!::::_ b" = 10'
@4"=--b"=--
Total Construction Cost
10% Service Charge
Let. No.: 1~54 Total Lateral Charge
Logged in Plat:
LINE COST DATA
A. D. & Assmt. No. )../OJVC°
11S,oo
<10,00
AJoWC-
JSf",O(
/S .Sl'..
/70,&-;t:>
LINE COST: ----------------
C. C. @ __ / dwelling ------S:,. {Y'
P. S. @ __ I dwelling -------------
OTHER ------------------=..1.
TOTAL / 2(') ' 5( •-
Grand Total, Lateral, etc. 7 2/) 'lil ")
FOR SEWER LOCATION
~·----------------1~
St. NORTH
ENGINEERING SEWER DEPT.
' Signed --------I Signed --------
lideted