HomeMy WebLinkAbout1741 BONITA LN; ; SE658470; PermitFOR APPLICANT TO FILL IN
CONTRACTOR
ADDRESS
TEL. NO.
CONTRACTOR'S =ATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO, I
1-1 ** I+
PERMIT
TOTAL F'EE I OWNER'S
AUTHORIZATION I I
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- ING TO WE PUBLIC SEWER.
SIGNED THIS DAY 6F OWNER OR OWNER'G AGENT I
SIGNATURE I OF PERMITTEE
CONNECTION DATA
Lateral Charge Computation
30' H., IO V. @ 4" = __ 6" = _I_
Add. Horiz. @ 4" = - 4" = _I
Add. Vert. @J 4" = - 4" = __
Total Construction Cost
10% Service Charge -
Total Lateral Chsrge
Cat. No.: Logged in pbk ,.__
LINE COST DATA
A. D. & Assmt. No.
LINE COST:
C. C. @L / dwelling
P. S. @- / dwelling
OTHER 1
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
&
st.
ENGINEERING SEWER DEPT.
Signed I Signed
I
' *' *-r* & g.* &w.r Permit When Properly Filled Out, Signed and Validated
hued By
PERMIT VALIDATION e-- .. t
8471; SEWER
BUILDING DEPARTMENT PERMIT - APPLICATION
PA10 t0-65 5~1581*******!LOO
FOR APPLICANT TO FILL IN I
LEGAL DESCRIPTION LOT NO.
TEL. NO. # PB-230’P
CONTRACTOR’S STATE CAR LS BAD B US1 NESS LICENSE NO. LICENSE NO.
0 $5.00 __
PRIVATE DISPOSAL SYSTEM
SEWER OR DISPOSAL SYSTEM
OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN..
CESSPOOL, DRYWELL. MANHOLE 8 $5.00
HOUSE SEWER CONNECTING TO
CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER
ALTER. REPAIR OR ABANDON HOUSE
@ $1.50 __
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO PUBLIC SEWER
SEPTIC TANK, SEEPAGE PIT OR PITS
OWNER’S I PERMIT 56
AUTHORIZATION TOTAL FEE
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 RE’AD THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATIWG PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE-DESCRIBED RESIDENTIAL- PROP
CONNECTION DATA Lateral Charge Computation
30’ H., IO’ V. @ 4” = __ 6” = __
Add. Horiz. @ 4” = ___ 6” = __
@ 4” = ___ 6” = - Add. Vert.
Total Construction Cost
lOyo Service Charge I__-
Total Lateral Charge _.-.____
Lo ed 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 $1 js
St. NORTH
ENGINEERING SEWER DEPT.
Signed 1 Signed
Tks is (I Sewer Permit When Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION