HomeMy WebLinkAbout1749 BONITA LN; ; SE658725; PermitSEWER
BUILDING DEPARTMENT PERMIT - APPLICATION
I FOR APPLICANT TO FILL IN I
LEGAL DESCRIPTION LOT NO.
CONTRACTOR'S STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO.
I
@* I+--
OWNER'S
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
CONNECTION DATA
Laterdl 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
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
st. NORTH
ENGINEERING SEWER DEPT.
Signed I Signed
/ This &&BC Permit When Properly Filled Out, Signed and Vafidated
luued By
PERMIT VALIDATION
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