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HomeMy Public PortalAbout9626 GIDLEY ST_Sewer__ `Y``° 76A 642D APPLICATION FOR PE`RMI 76A f COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSIONBUILDING JOHN A. LAMSIE, COUNTY KNOINEER ADDRESS [>L� COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY-� N Id R EST FOB APPLICANT TO FILL IN C.LEGAL fr DESCRIPTION LOT NO. OWN-Km PAIL SkOCK TRACT ADDRKSA cNO. OF PLOD•. L r ^ 0 SIZE OF LOT NOW ON LOT CI M. NO. U HIE 0■ DISTRICT NO. ORO MAPPR4CISAXD BY BUILDINGS P CONTRACTOR [O . ADDRLM COI XE=ON. ATA CITY <L NO. STATION DETTN STAT[ LIC MANHOLE REFERENCE L� R pprwR LICENSE NO, G(.ASS No. D¢BCRIPT-ION OF WORK Fu TYPE OF c6mH [CTIONLQIGTFl H tOM E HOUSE SWEA CONNEdTING TO Y. CURB P.L. M.L.TO P.LL ' PUBLIC SrW`KR so-00 SEPTIC AHK, AGE PIT OR P.C.NO. PITS AND/OR DRAINFIELD /10.00 CO.IMP. JOB GUS[SEW[R CONN[CTIN13 TO TRUNKTERMIT NO. PERMIT NO, PRIVATE DIf POSAL SYSTEM [9.00 CONNECT ADDITIONAL BLDG.6H AFFIDAVIT IF= R[ HSl'R.NO. DAT[ WORK TO HOUSE SEWER SS.OQ OVERFLOW/EEPAGE PIT.DRAINFIELD [I[TN.,C[1fPOOL DRYW[7<L MANN OLE Q /°.00 0 A BANDOOOf KV".OR 1161134INING CF..T DISPOSAL/YTT[YOR 03.00 LLI STATE lLkCFtOACHMKNT (L PERMIT NO. INOUSTR AL WASTIE AITROVAL CHARGES OWNEB'S PEUCT s 2 00 CONNECTION CHARGE FEE AOTHOBIZATION Tarxi. FEE I HAVE AT THIG DAT[ A LONTRACT WITH THE HEREIN NAMED CON. REIM°URIEYENT FEE TRACTOR TO,CONNXCTff ABOVE DESCRISED jjNQ DWELLINQ TO THA OVAiQ E PUBLIC S[WE DATE INSPECTOR'S SIGNATURE SIONEQ THIO DAY QF 10,71 OWNER ORNEW HOUSE SKWER OW N ERS AGE CONNECT ADDITIONAL ADONIS PUILDING OR WORK SEPTIC TANK.SEEP,Ply(S) I HEREEY ACKNOWLIDGE THAT.I 'HAVE READ THIS APPLICATION A-NQ/OR DRAINFIELP AND STATE THAT THE ABOVE Ib CORT RECAND AGREE TO COMPLY WITH ALL COUNTY O INAKC EI AND STAT[ -AWS k[b ULATING 1--1 PLU MSINO AND SEW CX"POOL Q DRYWELL La I HEREBY CERTIFY AT AM PROPERLY R[QISTIREO ANP/OR ALTER,REPAIR,SEWER OR 410EN•[D Al REOUI LOS ANGLES COUNTY A (TATE OF •[WAG[DISPOSAL/YST[M CALIFORNIA OR TH TH[ LIOAL OW D INTEND TO DISCONNECT PLUG AND R[SID[ IN, TN[ A [fC RI R[D REII I OPI RTY. ASANDON HOUSE SEWER •10F PER R[ /ACKPILL SEPTIC TANKS ElOF PRY [EF.PIT f*) CL CESSPOO4JAR, AMATION ALLEN K. M_U. CASN SUPERVISING MECHANICAL "OINEQR