HomeMy Public PortalAbout9537 WEDGEWOOD ST_Sewer__ DEP"f3lENP OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX. COUNTY ENGINEER I ADDRESS �` � N\/LOA(��+Ci9LCZl
FOR APPLICANT TO FILL IN LOCALITY
BUILDING ! NEAREST ^
ADDRESS g �rf �g'C We ftaWw-�, I CROSS ST. C' e,
A i DISTRICT NO. SERIAL NO. 25347
PERMI/TNO.
LOCALITY �1ft�j°le L7i1 c
NEAEST
CROSS ST.. amaxorly Ave 1 � A 2534 Ly - J
CEIVED BY Ready for Iaspeotion DATE.ISSUEDD
OWNER Kra AG R.oiabp. ticxg-qzl 0 -as-S4
MAIL
ADDRESS - USE ZO O-C-C}U-PANCY BK MAP PG
CITY TEL.NO.- i - A
CONTRACTOR (leer iib=g I C0:IMP.NO. I'aG2-
ADDRESS 6329SO GoMen No JOB NO.
CITY 'samAe.. TEL.NO, dti. •117a2 I TRUNK PERMIT NO.
STATEREGISTRATION NO. �fi7& ❑ COUNTY! ROAD PERMIT NO,LEGAa��pla
DESCRIPTION LOT NO.Il O=_ 0194 CM 'dam STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT A=os I INDUSTRIAL --
WASTE APPROVAL
NOSIZE OF LOT !�� NOW ON LOTS° CHARGES
BUDI
INpJa CONNECTIONCHA
NO. DESCRIPTION UP WORK FEE
REIMBURSEMENT FEE
/ HOUSE SEWER CONNECTING TO
PUBLICSEWER a $ 3.50 .[, 0 RECEIPT NO. DATE
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO. I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR ORA,NFIELO 2.00 STATION .4J, .4(o DEPTH
CESSPOOL-D RYW ELL
SPECIAL CONDITIONS ONLY 2.00 I �� .. P M �uPPE REFERENCE
TYPE OFC W ECTIO l LENGTH FROM
(CURB �'�-.� M.L.TO P.L. �0
OWNERS PERMIT ; I 00 ; '
AUTHORIZATION TOTAL FEE �d
1 HAVE.THIS DATE CONTRACTED WITH THE HEREIN NAMED.
CONTRACTOR.TO CONNECT THE ABOVE DESCRIBED EXISTING .
DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR' SIGNATURE DAYE
.
SIGNED THIS. _DAY OF_ _ .. __._1941 NEW HOUSE SEWER � s a.S
OWNER OR /� ,J, CONNECT ADDITIONAL
OWNERS AGENT��.. 1'!����Lf ._.�._.:_...�.._.�.arr_I BUILDING OR WORK
ADDRESS.___....__ ..___._._.._.._.._. SEPTIC TANK,SEEP.PIT(S)
.----_..___._,�._.._._. !....._.........._... AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI-' CESSPOOL[] DRYWELL 0
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE I
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. 7 SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED; DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT i AM THE LEGAL OWN-
ER OF THE ABOVE D CRIBED RESIDEN AL PROPERTY. BACKFILL SEPTIC TANKS
SEEP.PIT(S)E] CESSPOOLPrEe �..
SIGNATURE s
OF PERMITTEE,, .
76AS42A 663 7/53