HomeMy Public PortalAbout9225 ROSEGLEN ST_Sewer__ 9■-sea x*■
79,942D
APPLICATION FOR PERMIT
DriMON OF BUrLDI NG AND SAFETY SEWER—SEWAGE DISPOSAL _
of Thr
Cooatt of Los A 424 F"D G 2 $o S Street
WM.d. FOX, Coumw rNammm
Uity
CASSA7T D.aRIIFFIN,sur?of Ruftmmm rrt 1®FOR APPLICANT TO FILL ST p ST 4ncitas
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�1 G L Jack
D CRIPT10R LOT 110.• e�y fin, owm V ack Weaber .S�
BLOCK TRACT 24021 MAIL '222 S iJ B
I� •
N0. OF BLOCS.
SIZE OF LOT NOW OR LOT G 2 CMbgl 'W:tn P&rk TIL.NO. -
USS OF sidence .
UI INGS DISTRICT R0., GROUP
YAP
CORtRACTOR L,D.& M. CONSTRUCTION Co. '— /'Z
ADDRESS B 208 COMU=QN DATA
c1TYBaldwin Park na. No. ED 8 3024 $TUITION ♦e DEPTH
REGEMATIOR NO. 1130.13 , . [3 $ ■AI+HOLIi AfFERENCE — LOWS
No. DESCRIPTION OF WORK FEE
HOUSE 9; EEfft� CONNECTING TO TTPE OF COAXECT3 LENGTH FRO
PUBL1CSEMA 3.50 T• CURB. P. P. y
HOUSE SEWER CONNECTI 0 TO
AIVATE D13POSAL SYSTEM 1.00
CORRECT A TIONAL BLDG. OR F. C. NO.
MOHR TO HO SE.IYER 1.00 CO IMP. X0. �iE�RQ...
ALTER OR R-PAIR E](157IRG TRUNK PERf11T NO. ROAD PERMIT NO.
SEl1 OR DISPOSAL SYSTEM, 1.00
ISCQXXECT AND ABANDON SEW STATE EX
�ROACHYEXT
AD
OR DISPOSAL SYSTEM 1.00 PERMIT XC-
BEPTiC TANK, SEEPAG PIT aR
O.
PITS ARD/OR DRAIXFIELD .00 INbU IAL
CESSPOOL-D 1'�IELL I PROP L
SPECIAL COX I IONS ONLY 2.00 CHARGES
C0XXECTION CHARGE FEE -
OWNEi#'O >l i t o0
AUMQBTLATION I TOTAL FEE 4450 REIYBURSEMRT FEE
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAKED COX- AM
OVALS TO CONNECT THE ABOVE bGSCRIBED �IlBTIMg RWEt.J-ING A$PSOYALS DATE IMtF $tsXATUCi
TO THE PUBLIC SOVER
SIGNED THIS nAg p t9 "W HOUSE SETTER I
OlyNER OR aw CORRECT ADDITIONAL
NERS AGENT BUILDING OR OAK
SEPTIC TANK,>KEP,PIT($)
ADDRESS ARO/OR DRAIXFIELD
1 HEREB ACKXO*LEDGE THAT I HAVE READ THUS APPLICATION cmpOOL0 DRY►ELL❑
AND BTATIr THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY.
WITH A{,1.. COUNTY ORDINANCES AND STATE LAMS REGULA71NG ALTE'FT, REPAIR fE�SER QR
PLUMBING AND HEWERS. $EISAGEDI3 O�IAL 6Y Y
1 ER P$7 CERTIFY THAT I AY PROPERLY REGISTERED AIgD/OR
LIC{.E�ABri AS REQUIRED BY LO ANG OOUXTY AND $TATE OF DISCO ECT PLUqq AXb
DA FOR
QIAQ R THAT I AN PROPERTY.THLJOF Q 4IBOY ABAXdONHOUSE EEWER
.Ek
QIACIFILL SC TAXICf
L ri
PIT 8 CES$PO
$IGRATUAB
OF PERK
Wi 1 L,km,J.SOX, couNrr rNaLN VAIMMON R.A.WOOD. Cwmr F'Lua. INsrsbron'
2 1 3 3 ORMAR 19 4 A 450 1