HomeMy WebLinkAbout1744 BONITA LN; ; SE658468; PermitSEWER
NO.
BUILDING DEPARTMENT PERMIT - APPLICATION
DESCRIPTION OF WORK FEE
uo HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 ?
SEPTIC TANK, SEEPAGE PIT OR PITS 0 dS.00
OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN..
Auc 10-65 ?~1583**+****5.00 PA10
FOR APPLICANT TO FILL IN
DESCRIPTION LOT NO. /a
#- TEL. NO. CONTRACTOR'S STATE - CARLSBAD BUSINESS LICENSE NO. LICENSE NO.
CESSPOOL, DRYWELL. MANHOLE @ $5.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50
CONNECT ADDITIONAL BLDG. OR
OWNER'S I PERMIT s[stF - 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
I HEREBY ACKNOWLEDGE THAT I HAVE READ 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 LICENSED AS REQUIRED BY THE CITY OF CARLS- BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ERTY. SIGNATURE OF PERMITT
CONNECTION DATA Lateral Charge Computation
30' H., IO' V. @ 4" = __ 6" = __
Add. Horiz. @ 4" = __ 6" = -
Add. Vert. @ 4" = __ 6" = -
Total Construction Cost
10% Service Charge
Total Lateral Charge
tat. No.: Logged in Plat:
LINE COST DATA
A. D. 8r Assmt. No.
LINE COST:
C. C. @- / dwelling
P. S. @- / dwelling
OTHER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION ;I
st. NORTH
ENGl NEERl NG SEWER DEPT. I Signed Signed
fk is a Sewer Permitwhen Properly Filled Out, Signed and Validated
tsrued By
PERMIT VALIDATION