Form Ds 721 – Fill Out and Use This PDF

A copy of the paid invoice MUST BE SUBMITTED with this completed application.

Date:	Project No.:	Approval No.:	Invoice No.:
A refund in the amount of $_____________ is being requested for the following reason:

❏Permit /Approval Canceled (must provide a brief letter of explanation from property owner or permit holder)

❏Change in Scope of Work ❏ Duplicate Permit/Approval. See Permit/Approval No.: ______________________________

❏Other: (please explain briefly) ______________________________________________________________________________________

______________________________________________________________________________________________________________________

Refundable Party Information: (Note: If different from that person/entity listed as the “refundable party” on the paid invoice, include a letter from the “refundable party” authorizing the refund to be released to the person/entity listed below). Payments

made by credit card may be refunded to the same credit card.

Name:

Mailing Address:	City:	State:	Zip Code:
Telephone No.:	E-mail Address:

I hereby certify that no work authorized by the permit has been performed nor inspections provided.

Refundable Party Signature: _________________________________________________ Date: _______________________________

FOR DEPARTMENT USE ONLY

Service Address: (To be completed for Water /Sewer installation or capacity fee refunds)			NSSQ No.:
❏ Approved	$:	❏ Denied Reason:
Staff Name:		Signature:	Date:
Manager Name:		Signature:	Date:

Refund Policy:

1.There is a minimum refund processing fee of $91. An additional processing fee may be applied to refund requests that include water and/or sewer capacity fees, water meters or water/sewer service installations.

2.Refunds of inspection fees are not granted where a year or more has elapsed since permit issuance, or where work has started and inspections were made.

3.If a refund is the result of staff error, the entire amount of the overpayment will be refunded and the refund processing fee will be waived.

4.The following fees are not eligible for refund: General Plan Maintenance; Mapping; Issuance; Records; State Fees; Plan Check Fees, or other administrative fees.

5.Refunds for water/sewer capacity fees, water meters, or water/sewer service installations are forwarded to processed separately by the Public Utilities Department (PUD). Work canceled during the water and sewer installation stage will be verified that it is not complete prior to re- lease of any refund, and may be subject to partial refund of said fee. Completed work is not refundable.

6.Refund of County Water Authority (CWA) fees paid more than 30 days prior to the refund request may have to be processed separately by CWA.

7.Refunds of Facilities Benefit Assessments (FBA), Development Impact Fees (DIF), Regional Transportation Congestion Improvement Program (RTCIP), or Housing Trust Fund (HTF) linkage fees will be forwarded to and processed directly by the Facilities Financing Section of City Planning & Community Investment Department.

8.Refunds of school fees must be requested from the appropriate school district.

Printed on recycled paper. Visit our web site at www.sandiego.gov/development-services.

Upon request, this information is available in alternative formats for persons with disabilities.

DS-721 (02-11)