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HomeMy WebLinkAbout167 REDWOOD AVE; ; SE1971; PermitOTY Of CAfilSB% BUILDING DEPARTMENT •• - PERMIT - APPLICATION FOR APPLICANT TO FILL IN LEGAL DESCRIPTION CITY TEL NO CONTRACTOR'S STATE LICENSE NO. CARLSBAD BUSINESS LICENSE NO NO. .. .. DESCRJPtlON OF WORK FEE HOUSE .SEWER CONNECTING TO SEPTIC 'YANK." SEEPAGE PIT ORPITS; 9 »B.OO OVERFLOW SE'EPAO£ PIT PRAINFIELD EXTN .CESSPOOL, DRYWELL, MANHOLE 9 93 OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 9 $1 SO CONNECT ADDITIONAL' SLDG OR WORK TO HOUSE SEWER 9 $1 SO ALTER, REPAIR OR ABANDON HOUSE SEWER- OR DISPOSAL SYSTEM 9 $2 OO AuTHORlZATfQN e * PERMIT 9 TOTAL FEE 2 OO I HAVB fit THJS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD ING TO .^THft.PUBLIC SEWER OWNER OR; OWNER'S AGENT. ADDRESS,,. r HEREBYAPPLICATIONAND A5R1STATE L* . DAY OF. AND/OR BAD AND OWNER OF ERTY SIGNATUREOF PERMITTEE , THAT i HAVE READ THISAT£ THAT THE ABOVE js CORRECT* WITH ALL CITY ORDINANCES AND IHG .PLUMBING AND SEWERS. THAT t AM PROPERLY REGISTERED REOUIAED BY THE CITY OF CARLS-OF CALIFORNIA OR THAT i AM THE LEGAL E -ABQVE DESCRIBED RESIDENTIAL PROP* "' ' CONNECTION DATA Lateral Charge Computation ' " "• ,30' H., 10' V. Add Horn, Add -Vert LINE COST DATA A D, & Assmt No LINE ( C C. P S @ / OTHER , Grand Total, taterai etci* FOR SEWER LOCATION this 'n a Sewer Permit When Properly Filled Out, Signed and Validated Issued' By PERMIT VALIDATION