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Home My Public Portal About9252 WEDGEWOOD ST_Sewer__ DEPAICTNIENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION 1 COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS BUILDING FOR APPLICANT TO FILL IN LOCALITY ADDRESS fjl NEAREST -- -- -------- _... – –--_ CROSS ST. LOCALITY ^– DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST A S CROSS ST. OWNER RECEIVED BY Ready for Inspection DATE ISSUED ADDRESS `__ USE ZONE OCCUPANCY -.MAP- CITY TEL.NO. BK PG I I CONTRACTOR -- --- —— CO.IMP.N0, ADDRESS — —�_ JOB NO. CITY TEL.NO. -- TRUNK PERMIT NO. REGISTRATION NO. [] STATE LEGAL COUNTY ROAD PERMIT NO. DESCRIPTION LOT NO. STATE ENCROACHMENT BLOCK TRACT PERMIT NO. _— INDUSTRIAL SIZE OF LOT NO.OF BLDGS. WASTE APPROVAL USE OF NOW ON LOT CHARGES BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE --.-- p HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE j1 PUBLICSEWER $ 3.50 -- HOUSE SEWER CONNECTING TO RECEIPT NO. DATE I BY PRIVATE DISPOSAL SYSTEM 1,00 CONNECT ADDITIONAL BLDG.OR WORK TO HOUSE SEWER2.00 " EXCEPTION RECORDED ALTER OR REPAIR EXISTING NO. I SEWER OR DISPOSAL SYSTEM 2.80 DATE BY DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1,00 SEPTIC TANK.SEEPAGE PIT OR CONNECTION DATA PITS AND/OR DRAINFIELD 2,00 ESS £ CPOOL—ORYWLL STATION DEPTH SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ 1 00 Y• -CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTDWELLINGOTOTTHEONNECT PUBL CTHE SEWEROVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE a; SIGNED THIS..-.,-.,--: '....DAY OF. 19.......: NEW HOUSE SEWER f a OWNER OR CONNECT ADDITIONAL OWNERS AGENT.............:.._._ -_ BUILDING OR WORK ADDRESS......_.:-._._.._._......-__.... SEPTIC TANK,SEEP.PIT(S) -------------- AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL ED DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. ALTER,REPAIR,SEWER OR 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED SEWAGE DISPOSAL SYSTEM AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN. ABANDON HOUSE SEWER ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS ! SIGNATURE SEEP.PIT(S)[:] CESSPOOLS[7, 1 OF PERMITTEE.. i 76AG32D 663 1/53 E80a11 C�Ba� APPLICATION FOR PERMIT 1 1_S7 COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING - JOHN A. LAMBIE. Count. Engineer ADDRESS —' C1 MTT D. GRIFFIN.Sup t of Building LOCALITYI fNEAEST J FOR APPLICANT TO FILL IN CROSS ST. LEGAL -- -- -� DESCRIPTION LOT NO r'> OWNERMAIL - BLOCK TRACT' l f ADDRESS _ -NO.OF BLDGS. - - SIZE OF LOT d NOW ON LOT CITY 1 TEL.NO;,'• USE OF BUILDINGS DISTRICT NO. GR. U I MAP CONTRACTOR j 1G ADDRESS _ CONNECTION DATA CITY -TEL.NO. r STATION 1 - DEPTH - STATE MANHOLE REFERENCE. v UPPER. REGISTRATION NO. - - [] COUNTY ,-L� LOWER N0. 1 DESCRIPTION OF WORK FEE � - r �� `b �� HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $g, ;,,, SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM ITS AND/OR DRAINFIELD @ $3.00 Y. CURB P.L. M.L.TO P.L. OVERFLOW SEEPAGE PIT,DRAINFIELD - _EXTN.,CESSPOOL,DRYWELL,MAN HOLE @ $2.00 HOUSE SEWER CONNECTING TO P,C.NO. PRIVATE DISPOSA.T @ $1.00 CO.IMP.NO. JOB NO. CONNECT ADD I ¢�A BqG AR WORK 1-0 5F1IUjrait fir' +--$i•£'v' _ TRUNK PERMIT N0. ROAD PERMIT N0. ALTER,REPAIOR:ABANDON HOUSE SEWER OR DISPOSAL SYSTEM !g. $1.00 STAT.ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNERS 1PERMITTOTAL � 00 CONNECTION CHARGE FEE AUTHORIZATION FEE REIMBURSEMENT FEE I HAVE AT TRACTOR TO THIS THE ABO E DESCRIBED EXISTINGAMED DWELLIING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. ---- SIGNED THIS ..DAY OF--I 9— _NEW HOUSE SEWER OWNER OR CONNECTADDITIONAL -- OWNERS AGENT BUILDING OR WORK 1 SEPTIC TANK,SEEP,PIT(S) ~� AND,/OR.DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION T AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL 0 DRYWELL❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ---�--- PLUMBING AND SEWERS. ALTER,REPAIR,SEWER OR SEWAGE DISPOSAL SYSTEM I HERESY CERTIFY THAT i AM PROPERLY COUNTY AND AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF _ABANDON HOUSE SEWER CALIFORNIA OR THAT i A1,1 THE LEGAL. OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS ❑ SIGNATURE SEEP.PIT(S) ❑CESSPOOLS ❑ 1 OF PERMITTEE` VALIDATI® ROBERT A. WOOD CK. M.0. CASH SUPERVISING MECHANICAL ENGINEER 4 rh