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HomeMy WebLinkAbout1274 MAGNOLIA AVE; ; SE690010; Permit~Ti tf CARLSBD SEWER BUILDING DEPARTMENT PERMIT. APPLICATION FOR APPLICANT TO FILL IN LEGAL EJUILDING " DESCRIPTION LOT NO. ADDRESS I 1 BLOCK TRACT NEAREST <• CROSS ST. I USE OF H \. ~ ' l ' BUILDINGS OWNER ~ MAIL C, 1 CONTRACTOR ADDRESS ADDRESS CITY TEL. N O. CITY TEL . NO. CONNECTION DATA CONTRACTOR'S STATE CARLSBAD BUSINESS Lateral Charge Computation LICENSE NO. LICENSE NO. 30' H., JO' V. @ 4" = ---6" ;:: --- Add. Horiz. @ 4" = ---6" -NO. DESCRIPTION OF WORK FEE ---- HOUSE SEWER CONNECTING TO -Add. Vert. @ 4" ___ 6" -= PUBLIC SEWER @ $3.00 . ---- SEPTIC TANK, SEEPAGE PIT O R PITS 0 $!5.00 Total Construction Cost OVERFLOW SEEPAGE PIT, DRAINFIELO EXTN,, JO% Service Charge CESSPOOL, DRYWELL, MANHOLE @ $5.00 HOUSE SEWER CONNECTING TO Total Lateral Charge PRIVATE DISPOSAL SYSTEM @ SI.SO --CONNECT ADDITIONAL BLDG. OR Lat. No.: Lo22ed in Plat: WORK TO HOUSE SEWER @ $1.50 --ALTER, REPAIR OR A BANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.00 LINE COST DATA ---- @ $ A. D. & Assmt. No. --LINE COST: ~ - OWNER'S I PERMIT $ 2 00 C. C. @ __ I dwelling ;. ,. AUTHORIZATION TOTAL FEE P. S. @ __ / dwelling OTHER I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD· TOTAL ING TO THE PUB L IC SEWER. SIGNED TH IS DAY OF Grand Total, Lateral, etc. OWNER OR OWNER'S AGENT FOR SEWER LOCATION ADDRESS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT TH E ABOVE IS CORRECT ..: .. AND AGREE TO COMPLY WITH A LL CITY ORDINANCES AND V) V) STATE LAWS REGULATING PLU MB ING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED B Y THE CITY OF CARLS- BAD AND STATE OF CAL IFORNIA OR THAT I AM THE LEGAL St. OWNER OF T HE ABOVE DESCRIBED RESIDENTIAL PROP· ENGINEERING SEWER DEPT. ERTY. SIGNATURE OF PERMITTEE Signed I Signed This is a Sewer Permit When Properly Filled Out, Signed end Validated Issued By -------------------- PERMIT VALIDATION NORTH