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Home My Public Portal About9231 WEDGEWOOD ST_Sewer__ 76AV642D -CGB08-10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER .y BUILDING AND SAFETY DIVISION BUILDING ADDRESS ✓S � i(_. LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL D_ESG_RIPTION LOT NO. 1 OWNER MAIL BLOCK TRACT ADDRESS SIZE OF LOT - `� J, C�^�1 NOW ON LOT CITY TEL. NO. USE OF 7 BJ ILDI NGS DISTR ICT NO. GROUP Bj� MAP PS PRO SSED BY CONTRACTOR ADDRESS C6NNECTION DATA 7 STATION �4 DEPTH CITY--,�4 TEL. NO. IS -3 4' LICENSE NO. /)�,)-' jf, (/�^ CLASS (�9 MANHOLE REFERENCE /°J' � STATE -a fy?'L�`- l LOWER NO. 1 DESCRIPTION OF WORK FEE TYPE OF &T N LENGTH FROM HOUSE SEWER CONNECTING TO �. Y. CUR P.L. M.L.70 P.L. PUBLIC SEWER 0 $7.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR _G' PITS AND/OR DRAINFIELD $10.00 CO.IMP.NO. > 3 yJOB NO. C HOUSE SEWER ONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. -' `7 54. a PRIVATE DISPOSAL SYSTEM $3.00 _ ..j''J CONNECT ADDITIONAL BLDG.OR �J' AFFIDAVIT WAIVEI EASEMENT RECORD.INSTR. NO. DATE (� WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT.DRAtNFIELD EXTN..CESSPOOL.DRYWELL. 0 $5.00 O ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING }- _ SE_W_ER OR_D_ISPOS_AL SYSTEM @_$3.00 STATE ENCROACHMENT Lu MANHOLE $7 00 PERMIT NO. H — -- --------- ----- INDUSTRIAL Z WASTE APPROVAL OWNERS PERMIT $ 3 00CHARGES} AUTHORIZATION TOTAL FEE /i CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE 1 Py TOR'S SI NATURE SIGNED THIS A 19_ OWNER OR / p-'/y� NEW HOUSE SEWER """""""` OWNERS AGENT ---^-- CONNECT ADDITIONAL ADDRESS-- BUILDING OR WORK __ SEPTIC TANK,SEEP,PIT(S) 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY -- WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL 1 HEREBY CERTIFY THAT 1 AM PROPERLY,REGISTERED AND/OR ALTER.REPAIR.SEWER OR LICENSED AS REOUIR BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT AM THE LEGAL O R OF', AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE AS E DESCRIEk0ISI IAL PROPERTY. ABANDON HOUSE SEWER " SIGNATURE OF PERMITTEE Gyf� l BACKFILL SEPTIC TANKS El'�� --- �`' ,'' SEEP.PIT(S) El CESSPOOLS ❑ + � ` ✓ VALIDATION CK. M.O. CASH '6A 642D -CE808-10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FOS 'f r FOR APPLICANT TO FILL IN . Z,Iv LEGAL -- -- + / _ 71 — _DESCRIPTION LOT NO. ( Ll/F'7' OWNER ✓ ,sL- ./]� �1r MAIL BLOCK TRACT 14 Y'� ADDRESS _ 1.F SLOGS.NO. OF BLDGS. SIZE OF LOT J f NOW ON LOT CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PRO BUILDINGS C SED BY _ BK P�y GONTRACTO ADDRESS ' d CONNECTION DATA CITY TEL. NO. � ' STATION DEPTH STATEp`,,, LIC MANHOLE REFERENCE UPPER LICENSE NO. ♦�,,*' CLASS LOWER NO, DESCR( TION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER 0 $7.00 SEPTIC TANK.SEEPAGE PIT CIR P°C NO. PITS AND/OR DRAINFIELD $10.00 CO.IMP.NO. U NO, HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. CL PRIVATE DISPOSAL SYSTEM @ $3.00 O CONNECT ADDITIONAL BLDG.OR ,►- AFFIDAVIT wAIYFR E [N RECORD.INSTR.NO. DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CES5POOL.DRYWELL. @ $5.00 - O ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDE H SEWER OR DISPOSAL SYSTEM @ $3.00 _ STATE ENCROACHMENT Lu MANHOLE $7.00 PERMIT NO. CL -- --- INDUSTRIAL N WASTE APPROVAL z CHARGES Z OWNERS PERMIT $ 3 00 AUTHORIZATIONJ TOTAL FEE • c CONNECTION CHARGE FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER, APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ e OWNER OR NEW HOUSE SEWW OWNERS AGENT CONNECT ADDIT -i1-11L ADDRESS BU I LDI NG OR) K —' SEPTIC TANK.SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY — WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL Q 1 HEREBY CERTIFY THAT, 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR:SEWER OR LICENSED AS REQUIRE - LiPS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT T E LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE AS CRI BED RESIDENTIAL PROPERTY. ABANDON HOUSE SEW R. SIGNATURE _� _ w'�^-� BACKFILL SEPTIC TAf�KS ❑ PERMfTTEE, SEEP.PIT(S) [ .-�6, SPOOLS VALIDATION 5`` CK. M.O. SASH r! F7 �'. �,•�� _ � .fir 10 -1 6.0 0'