HomeMy WebLinkAbout1279 Knowles Ave; ; SW669542; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK
USE OF
BUILDINGS
CONTRACTO
ADDRESS
CITY
CONTRACTOR"& STATE
LICEN#,0. ,4
1
TEL. NO.
CARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
I HOUSE SEWER CONNECTING TO ~ PUBLIC SEWER • $3.00
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 $15.00
OVERFLOW SEEPAGE PIT, DRAINl"lltLD EXTN.,
CESSPOOL, DRYWELL, MANHOLE • $15.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 0 $1.150
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER 0 $1.150
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM 0 $2.00
• s
OWNER'S PERMIT s 2
AUTHORIZATION -TOTAL FEE
0 C)
00
I HAVE AT THIS CATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE CESCRIBED BUILD·
ING TO THE PUBLIC SEWER.
SIGNED THIS -----DAY OF ---------OWNER OR
OWNER'S AGENT----------------
ADDRESS
SEWER
PERMIT • APPLICATION
., ,,~ !'::1na1•• .. ••50.00
Stp;11-•c. ::Ll'l.l -~O o
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V. @ 4" = --6"=--
Add. Horiz. @ 4" = __ 6"=--
Add. Vert. @ 4" --6" =--
Total Construction Cost
I 0% Service Charge
Total Lateral Charge ____ _
Lat. No.: Lo ed in Plat:
LINE COST DATA
A. D. & Assmt. No. ----------------
LINE C~T: --=-----------___ _
C. C. ~~dwelling _,._/ ______ ,,S--t') c,o
P. S. @ __ / dwelling _____________ _
OTHER-------------------
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
~1----------------l~
St.
ENGINEERING SEWER DEPT.
NORTH
Signed ________ _ Signed ________ _
This is • Sewer Permit When Properly Filled Out, Signed end Validated
Issued By _________________ _
PERMIT VALIDATION