Form Ds-721 - Refund Application - City Of San Diego Development Services - 2016
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City of San Diego
Development Services
Refund Application
DS-721
1222 First Ave., MS-301
San Diego, CA 92101
(619) 446-5000
M
2015
arch
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)
_____________________________________________________________________________________________________________________
Requested by Name:
Telephone No.:
E-mail Address:
(Please print)
Signature: _________________________________________________
Date: ________________________________________
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. Refunds of water/sewer capacity fees, water meters, etc., will only
be returned to the person/entity who paid the original invoice.)
Name:
Mailing Address:
City:
State:
Zip Code:
FOR DEPARTMENT USE ONLY
Clear Form
Service Address:
Credit Memo No.:
(To be completed for Water /Sewer installation or capacity fee refunds)
❏
❏
Approved
$:
Denied
Reason:
Staff Name:
Signature:
Date:
Manager Name:
Signature:
Date:
❏
Environmental Services Department (ESD) Canceled projects only
❏
Forwarded on ___________________to:
Public Utilities Department (PUD)
❏
Facilities Financing (FF)
❏
Support Services (DSD)
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 when any plan review has been performed: General Plan Maintenance; Mapping; Issuance; Re-
cords; 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 and processed separately by the
Public Utilities Department (PUD).
6. Refunds or partial refunds of Facilities Benefit Assessments (FBA), Development Impact Fees (DIF), Regional Transportation Congestion
Improvement Program (RTCIP), or Housing Trust Fund (HTF) fees will be forwarded to and processed by Facilities Financing.
7. Refunds of school fees must be requested from the appropriate school district.
Printed on recycled paper. Visit our web site at
Upon request, this information is available in alternative formats for persons with disabilities.
DS-721 (03-15)
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