HomeMy WebLinkAboutX2020-0912 - MiscCosta Mesa Sanitary District
...an Independent Special Distric
SEWER PERMIT
BUILDING ADDRESS:20291 Riverside Dr, Newiwri Beach, Caliro
PARCELNO; 43924134
PROPERI'VOWNER NAME: ANDERSON GARY
APPLICANT NANIL!Mig❑el Hernandez
PHONE NO.: 310-487-6567
CONTRACTOR NAINIE:OwNER BUILDER
PHONE NO.:
CONTRACTOR ADDRESS:
CITY:
STATE. LICENSE NO:NlA
STATE: 7,1P:
WORK TO Br DONE:
SFR; ADDITION & REMODEL
I hereby acknowledge that I have read this application and state the above is correct and agree to comply with State
laws, City and County orldinaees and Sanitary District ordinances pertaining to santt 13 sewer I certify l possess
the above valid State of California contractor's license or am legal owner of property d r - bove.
_It
-�L
Agnat of LPermittee3
Date
Pursuant to the Costa Mesa Sanitary District Operations Code, section 6.8.060, Orange County Sanitation District
pretreatment requirements are herein incorporated by reference.
OFFICE USE ONLY
PERMIT FEE: $ 140.00 PERMIT NO.: CMS21-0007
FIXTURE FEE: $ 34.50 PERMIT ISSUED BY: Bso Vong_ _--,. - _ 0310.1.12021
PLAN CHECK FEE: $ 150.00 INSPECTED BY: DATE
CSD FEE: $ ®® CCTV: YES NO DATE
TOTAL FEES: $ 324.50 APPROVED: YES NO
Notes:
IMPORTANT INFORMATION
The Sewer Permit is not effective without an authorization signature. This Sewer Permit is not a contract until it
has been accepted. Acceptance is subject to the following:
1, All sewer connections must be inspected- call CMSD (949) 645-8400.
2, This sewer permit is subject to all Terms and Conditions that are stated separately but
incorporated herein unless this sewer permit specifically states otherwise.