HomeMy WebLinkAbout1734 BONITA LN; ; SE658726; PermitBUILDING DEPARTMENT
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO 4 PUBLIC SEWER 0 $3.00
SEPTIC TANK, SEEPAGE PIT OR
OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN..
CESSPOOL. DRYWELL. MANHOLE 8 $5.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50
CONNECT ADDITIONAL BLDG. OR
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM 8 $2.00
PITS @ $5.00
WORK TO HOUSE SEWER 8 $1.50
PERMIT - APPLICATION
259**** ***5.00 OCT -1 -65 fr PA10
00 2 -
I ~~~~~ ~
FOR APPLICANT TO FILL IN
LEGAL DESCRIPTION LOT NO. I
1
CITY (- cq~/,q TEL. NO. 729-23/f
CONTRACTOR'S STATE CARLSBAD BUSINESS I LICENSE NO. LICENSE NO.
I -I I+ I II I OWNERS - AUTHORIZATION
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 6F OWNER OR OWNER'S AGENT
BUILDING ADDRESS 173%
NEAREST
CONNECTION DATA Lateral Charge Computation
30' H., IO' V. @ 4'' = - 6" = -
Add. Horiz. @ 4" = - 6" = -
@ 4" = __ 6" = __ Add. Vert.
Total Construction Cost
10% Service Charge
Total Lateral Charge
Lat. No.: Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.
LINE COST:
C. C. @- / dwelling
P. S. @- / dwelling
OTHER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE RSAD THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LIC TYE CITY OF CARLS- BAD AND ST HAT I AM THE LEGAL OWNER OF RESIDENTIAL PROP
rly Filled Out,
Issued By
PERMIT VALIDATION
St. ' NORTH
ENGINEERING SEWER DEPT.
Signed 1 Signed
Signed and Validated