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�w8APPLICATION FOR PER IT 1
COMM OF LOS ANGT SEWER—SEWAGE DISIL
MA=MMfT OF COUX" EnaU=a
BMW=(; MCD SAFM DXVIMOH BUILDING
JOEM Ca=dy ADD
RISS
CAORM D. (ZLTFDU Oup't of DvIIdaQ LOCALITY
OH APPJ1=M TO MI Di
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DESCRIPTION 110.
BLOC[ TRA RAIL
ADDRESS
No.DF BLJYGB.
SIZE OR NOW 0 0
USE OP
BUILDINGS DI CT NO GROUP LAP PROCIaERED
H[ fG
CONTRACTOR
ADDRESS N ATA
CITY N0. STATION D[PTH
STA LAH >i Cti
REGISTRATION A0. � HOL� COUNTY
NO. I DV RIPTION-UrWORK
poefTc coHAEcnNG To a.00 I
�p�I �/{)( ��p/►Qt TTPE OF CONNEcn0N L[P(GTH FROM I
PlyTgf�pAIL1OD�/OgQ�DpkA1MgFI�ETLDITgOAQT. CURB .L 1.L.TO P.L
EITN. CESSP00 ADIiTrEL LAIIHOLI 2'00
HOUSE SEWFA CONNECTING TO, P.C.NO.
MUTATE DIMSAL STSTEL 1.00 �E-1tAr
CONNCT ADDInO�{�BLDG.OR TRUNK PERMIT NO. ROAD NO.
WORT HOUSE Hfi7ER 1.00
SAh&ORDASIOAHOUSE STA ENCROACD ■ 1.00
PnxrT N0.
In
mmyn
GRASSES
Ovnilm's PEOM CDP(KKCTION G[m
AUTSOE ATION I TOTAL FM ilia
I HAVE AT THIS DAYS A CONTRACT WM ME HEREIN 1A® CON.
TRA a TO CONN THE ASOY[ DESCRIBED �snNG IMMUNGIMMUNG AMOY DATX INSPECTOR'S ataluTURR
To TT PUBLIC
SIGNED THIS- T 1 NL7 HOUSE Sent 'Q f
OWNn 012. ^� CONNECT wDmONAI.
OWNERS A BUILDING OR WORK
C TAA[ LEEP,PIT(S)
ADD AN OR
DRAINFIELD
LY ACKNOWLEDGE T I HAY[ REJW THIS APPLICATION
E THAT I ABOVE 1S CORRECT ARD AGEEE.TO COIBLT CE�OOL DRTWELL COUNTY I)INAACES AAD STAT= LATS REGULATING ALTER.REPAIR.SEW 09
AAD SEWEXIL STVAGE DISPOSAL SYSTEM
BY CERTIFY THAT I Al rftOPlat1T RIGISTQED AI1D�bMDISCONNECT PLIIG AAD
AS REgOIRED BT LOS AAGELIS COUNTY AID STATE Of ABANDON HOUSE SEWER
22
CALIFORNIA O THAT 1 7Hfi LLaAL OW11SJ: OF 7HEOYK rrM
Or TION ROBERT A.WOOD
aK
11.0. Call SVPXRVIISINGI bRICHANICAL KNC;INMM
!r Co 4 9 0 -0,'::' na` 11 1 D 5 .00