HomeMy Public PortalAbout5640 ROSEMEAD BLVD_Sewer__ • DEPAWnIOWr OF ooUNTr SEVYE"EWAGE DISPOSAL 1
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WILLIAM J. FOX. COYNTY ENYINttY BUILDING
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I HAVE THIS DATE 000TRAWK01 WITH THE NEREIM MAYED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPROT01M016MATUM DATE
DWELLING TO THE PUBLIC SEWER
SIGN®THIS---DAY OF iqL_ NEW Nouns MWER
OWNER OB OOMMECT ADDITIONAL
OWNSRB ANENT BUILDING OR WORK
SEPTIC TANK.BEEP.PITO
ADDRESS— - AMO/ORDRAINFIRLD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL 0 DRYWELL
CATION AND BTATE THAT THE ABOVE IS CONVECT AND AORE6
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dBill@ AN SEWED NOES AND BTATR LAWS ALTER.NEPA_Il SALSEWER SYSTEM
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1 HEREBY CERTIFY THAT 1 AM PROPERLY ■ESISTEMED BEWARE DI
AND/OR UOKMRD AB REQUIRED BY LOS ANOELES MUM TY DISCOMNEOT FLUB AND
AND STATE of CALIFORNIA OR THAT I AlReArliff LEGAL O ABANDON HOUSE SEWER
BE OF THE ABOVE D BED R D M L P �RTY AM nn
sEEMPITCA CRESP000
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