HomeMy WebLinkAbout1395 OAK AVE; ; SE680351; PermitCITY OF CARLSBAD
BUILDING DEPARTMENT
LEGAL
DESCRIPTION
BLOCK
USE OF
BUILDINGS
FOR APPLICANT TO FILL IN
LOT NO. co
TRACT
CONTRACTOR o w 1Y M
ADDRESS 413 HA n o a
CITY L Q [3 ls /1b Q TEL. NO.
CONTRA6~R'S STATE CARLSBAD BUSINESS
LICENSE NO. LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO "" PUBLIC SEWER • $3.00 d
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 $!5.00
OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,
CESSPOOL, DRYWELL, MANHOLE • $!5.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM • $1.150
CONNECT ADDITIONAL BLOG. OR
WORK TO HOUSE SEWER • $1.!50
ALTER, REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM 0 $2.00
• s
OWNER'S PERMIT \n s 2
AUTHORIZATION TOTAL FEE 5
00
00
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 READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND
STATE LAWS REGULATING PLUMBING ANO 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 'RESIDENTIAL PROP.
ERTY. SIGNATURE
OF PERMITTEE ---------------
BUILDING
ADDRESS
NEAREST
CROSS ST.
OWNER
CITY
SEWER
PERMIT. ~ATION
An5 r~2 <'n · ..tt. 10-6ov.,.cc 89 **~* K) . ..iU'
..tt. 10-68 ~ 898***** I /U.JU ·
........ :-. .::.-97****** U.vU ·
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V. @ 4" = __ 6" = __
Add. Horiz. 1-{ @ 4" = 10 6" = __
I \t:,_00
40.0'."'1
Add. Vert.
14:)u_ ?CJ/
(:f-1--I f-1 '.:)-,
@ 4" = --6" = -------
Total Construction Cost
10% Service Charge
Lat. No.:
Total Lateral Charge'_I_,_;_..;...,;....:._
Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.------------~-'---
r r 1 :· 1~, LINE COST: _________ ...._ __ -----
C. C. @ __ / dwelling -------_._C:.._0_. __
P. S. ®--/ dwelling -------------
OTHER
TOTAL
FOR SEWER LOCATION
NORTH
SEWER DEPT.
Signed --------
This is e Sewer Permit When Properly ~Out, Signed and Velldated
l11ued By ~~ ~dJ;;:;
PERMIT VALIDATION