HomeMy WebLinkAbout1750 BONITA LN; ; SE658469; Permit8469 EWER
PERMIT - APPLICATION gPM@ A% 10-65 -~1582*ff***'S.OO
FOR APPLJCAM TO FILL IN
BUILDING
- CARLSBAD BUSINESS LICENSE NO. 2083 0s
Ng t&pOCRlPTlON OF WORK FEE
HWSE SEWER CONNECTING TO PuSLiG SEWER
OE$WC: TANK, SEEPAGE PIT OR
I OVfRPLOW SEEPAGE PIT. DRAINFIELD EXTN..
, PI-
- AUTHQR4UtlON
I HAM AT THIS DATE A CONTRACT WITH THE HEREIN CONfRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- ING TO THE PUBLIC SEWER.
SIGHED THIS DAY OF OW"# OR OWNERS AGENT
ADDP1&gS
I HEREBY ACKNOWLEDGE THAT I HAVE REaAD THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE 70 COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HER€SY 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.
CONNECTION DATA Lateral Charge Computation
30' H., IO' V. @ 4" = _I 6" = -
Add. Horiz. @ 4" = - 4* = -
Add. Vert. @ 4" = __I 4" = -
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. 8- / dwelling
OTHER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
st. NORTH
ENGINEERING SEWER DEPT.
Signed I Signed
%i PI a Swer Permit When Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION