HomeMy Public PortalAbout5474 BARELA AVE_Sewer__ APPLICATION FOR PER IT
COUN" OF Los Axa SEWER—SEWAGE D I S L 1
DWAMUM OF COUxrz ENS
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BLOCK TAI L
ADDRESS
NO.OF BLDGS. Q
SIZE OF LOT NOW N
USE OF
BUILDINGS DISTRICT N0. ¢POUF IAP PRO BT
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CONTRACTOR
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WORE TO HOUSEDITIML BLDG.OR 1.00- Tito"PH)I3IT N0. ROAD PMUM NO,
ALTF3t.REP II O�REIAA DO HOUSE 1.00 STATE EXCROA
SE7ISP OR D SPW►L fTSTEl FER■IT NO.
INDUSTRIAL
APPROVAL
CHARGES
QWNEWS PEBMIT oo CONNECTION C$APGE FEE
AUMOHPLATION I TOTAL FBS U WEiBURNMEr FEI
I HAVE AT THIS DATI A CONTRACT WITH THI M N MIND CON. QV DATI INDl
TRACTOR TO CONNECT THI ABQVK DESCWIKD XUBn■G DWRLLING CTOP'E fIGMTLTPE
TO THE PUBLIC
SIGNED AY nW NIW HOUSE SEWIER
OWNIER OR CONNECT ADDITIONAL
OWNERS AG BUILDING OR WORK
C TANK,SEE! PIt(f)
ADD AN R DRAIAF.
I HEREBT ACKNOWLEDGI THAT I HAVE THIS APPLICATION
AAD STATE UAT THE ABOVI iS CORRECT AGRE'I TO COIPLT CKSSPOOL DRTWHLL El
WITH ALL UATT ORDINANCES AND STATY LAWS RIGULATING ALTEI},RgAIR�SEWER 0R
PLUMBING AAD SEW13M SEWAGE DISPOdAL STETF)Y
I HEREBT CMM PT THAT I AM PROMLT NEG1117M ID AND/ DISCONNECT PLUG AND
LlC�1S'� AS REQUIRED BT L03 IAMCOUNTY AND STATE OF ABANDON HOUSE SEWEI
CALIFORNIA OR THAT I AN THE LEGAL OWITm AIVYX
DFECRIB[D ENTIAL FROCKFILI C TANKS❑
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4 CESSPOO Ls El
OF PERI
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at ■.a CLEM 9UTE1TVMNO MECHANICAL ENGINXVt
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