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HomeMy Public PortalAbout9164 BIDWELL ST_Sewer__ 6AB4xD C1180910-83 raA,eaAPPLICATIO FOR PE,RMI �1 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL -D$PARTMENT OF COUNTY ENGINF.EE BUELDING AND SAFETY DIVISION SU ILDINO oe rr0EE1 A. LADOM Co=ty EmqbLow ADDRESS WU11AM & YEMEN, Sup'f of DullcHnq LOCALITY � N[ARKAT LI FOR APPCANT T FILL IN "`G// ST. DfCRIP7 EI1ON LOT NO. WN OER MAIL MLO-CK "Cr ADDRESS o ■ e /IZI OF L NOW H LOT CITY TirL. Nb. US[ QF It DISTRICT No. GRQUP Mil' "nLeSkD BY ■UILDIN ■K PG CONTRACTOR A00R CO CTI DATA CI ATION / DEPTH Goo, '�'� MANHOLK REF[R[NC[ LOWER REGISTRATION NO. COUNTY No. DESCRIPTION OF WORK FES TYP[OF lort LtryoTf+rROM HODS[BUYER C,ONN[CTI-NG TO Y. C N.L PUBLIC SEWER Q 85.00 7 IC A Ka S PAG[PIT OR JOB NO. PIT/AND/OR DRAINFIFLD 41 •10.00 CO.IM,.NO. O V HOU/[/[W[R CONNECTING TO TRUNK PERMIT No. ROAD PS;VR. NO. 2 � �4 PRIVATI DISPOSAL SYSTEM •/.00 CONNECT ADDITIONAL BL-D(3. O AFFIDAVIT EA)1[n [1un[[7 RECORD.IN1TR.H DATE O WORK TO MOUS[SK"R S9.O0 OVERFLOW S[[P.�G[TIT,DRAINFI[LD S)LTN.,CES■POOL,DRYWELt,FIA NOL[a X5.00 L3, L R,R AIR O NDO HWY.OR FT,WIDENING yY SEW"OR DISPOSAL SYSTEM 11.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIA-L WASTIL APPROVAL CHARDO OWNEErS PmbuT s x o0 AUTHORIZATION TOTAL FEECONHSCTJON CHARD[FE[ r '1 HAVE AT THIS DATE A CONTRACT WITH TH[HEREIN <D CON- R[I MBURIYSMSNT FKK R TACTOR TO CONNECT TH[ AND RFIID T TO TH[ IF SEWER• OVA1� DAT[ INfP[ D11'S-SIONATU R[ SIGNEQ THIS OWNER OR NEW HOU■[SEWER OW N[RS AO[NT CONNECT ADbITIONAL BUILDING ORWORK AQDRES/- S[rTIC TANK,S[[P,PITM) I H[R[SY ACKNOWLEDGE [THAT I HAVREAD THIS APPLICATION DRL AND/OR AINFIED AND STAT[ THAT-THK ABOVE I■ CORRECT AND AOR[I TO COMPLY WITH ALLCOU R [ S DINANCl AND TAT[ LAW/ R[OULATINQ PLU MSING AND SIVINRig. CESSPOOL ❑ D)1YWEL,L ❑ 1 H[R[SY C[ T I AM PROPERLY GIS7ER AHO/OR ALTER,REPAIR./EWER OR LIC SED I QU LOS ANGLES AND BYATE OF SEWAGE D191- / L SYSTEM CALIFORNIA O I TH[ LIE AL O OF, AN INTEND TO D/GO N[CT PLUO AND RR/ID[ IN, W ESCRI BED R NTI ABANDON HOUSE SSWER SIGNATURE BACKFII-L SEF lC TANKD d OF FERMI SEEP,PITS) ❑ C-OOLJ VALII3 ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. H 0 0 8 3�g MR:3 Q 1 0 D 7,00 "