HomeMy WebLinkAbout1590 BASSWOOD AVE; ; SE751731; PermitAPPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
MAILING ADDRESS
CITY OF CARLSBAD
EN GIN E E RING DEPARTMENT
438-5541
,->A&qe - ,
FOR APPLICANT TO FILL IN
1
CONTRACTOR I
CONTRACTOR'S ADDRESS I I
NEW BUILDING I EXISTING BUILDING I
bEGAL DESCRl PTl ON
LATERAL LOCATION
,, +I
ST.
LATERAL NO. INSTALLATION DATE
I !I ,
ISSUED BY
DATE ISSUED
VAL1 DATION
STANDARD 4" (Max. H. 30', V. 10')
OVER30'H. @ FT.
OVER10'V. @ FT.
STANDARD 6" (Max. H. 30'. V. 10')
OVER 30' H. @ FT.
OVER '10'V. -@ FT.
TOTAL CONSTRUCTION COST
SERVICE CHARGE (REPAVING ETC.)
TOTAL LATERAL CHARGEL--
LINE COST DATA
ASSESSMENT DIST. NO.
FRONTAGE COST PER FT. TOTAL ---"I
OTHER
CONNECTION FEE
PUMP STATION FEES
NO. UNITS-COST PER UNIT TOTAL -... I*
i\
i
TOTAL C~~ARGES (LATERAL ETC.)
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