HomeMy Public PortalAbout9729 WEDGEWOOD ST - Sewer Eer
S 420&E-GPi3 3.53 APPLICATION ■ YPERMIT. PERMIT 'L/ ' - ■ .
S&
DIVISION OF BUILDING AND SAFETY SEWER-SEA IE DISPOSAL
Department of County Engineer
County of LOS Angeles BUILDING
WM.J.FOX, COUNTY ENGINEERADDRESS
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CASSATT 0.GRIFFIN,SUPT OF BUILDIN43 LOCALITY ` d -
FOR APPLICANT TO FILL IN _NEAREST
-_
CROSS ST.
LEGAL
DESCRIPTION LOT NO `OWNERR
4L4-1-
BLOCK TRACT MAIL
- NO. OF BLDGS. ----^� -�--
-
_SCZE OF:LOT NOW ON LOT ' CITY TEL. NO..~ � � ,Y3�>'
USE OF
BUILDINGSDISTP'.CT NO. { GROUP MAP
y +-- -- ---- i
SK PG
CONTRACTOR `° °+'"'' - e„c-,�✓' _� ! ' _
ADDRESS CONNECTION DATA
CITY -w- `"°'+�- TE N0, -- , ' �— STATION-- —'--. DEPTH
~ (��°•^STA17E MANHOLE REFERENCE - ti
� — a
REGISTRATION NO. '� ,��'.-: _ ^u COUNTY
No,I
DESCRIPTION OF VIORK FEE "'.L- -- __--- --
--- TYPE OF CONNECTrON LENGTH FROM
HOUSE SE ER P L TO P.L.
CUNNECTING TO Y. CURB
--� PUBLIC SEWER �; $
------ - —. _ ----- ..
HOUSE SEWER CONNECTING TO
—j— -PRIVATE DISPOSAL SYSTEM LOO
I `—",-y___. -- ------ - - — ------
ADDITI
—I CONNECT!j2USED EW BLDG. OR I- .�+-- P C N0-
dChK 70 HOUSE SEWER 1.00
- { ALTER OR REPAIR EXISTING
Sc;NtSTATE.ENCROACHMENT
R_OR D SrOSPt SYSTEM _ t.00 TRUNK PERMIT NO. ROAD PERMIT NO.
DISCONNECT ANQ AE1id DON SEWER
AND/UR DISPOSE{ Y.. th' 'ADO
SEPTIC TANK SEEPAGE PIC OR PERI t'f NO._
PITS AND/OR DRAINFiELD �2.000INDUSTRIAL ,
--- -- - -- WASTE APPROVAL.
CESSPOOL-DRYWELL
SPECIAL CONDITIONS ONLY 2.9D�- _ - CHARGES j
—__ _.« --.CONNECTION CHARGE FEE '-----_._--------_..—.-----I
OVMEWS —PERMIT S 1 40 —- -- ---- -- 1'
AUTHORIZATION TOTAL FEE - � --- REIMBURSEMENT FEE ^----��--
i HAVE THIS DATE CONTRACTED WITH THE HEREINNAMED CDN7t
TRACTOR T6 CONNECT THE ABOVE DESCRIBED EXISTING DlYEL1.iNG APPROVALS DATE INSPECTOR'S SIGNATURE,
TO THE PUBLIC SE4'lER -
-- - --:
SIGNED THIS_ —_.._DAY OF. .---- New HOUSE SEWER
OWNCR OR - CONNECT ADDITIONAL
OWNERS AGENT___.___.,__...__.w__._._ _BUILDING OR WORK
SEPTICTANK, SEEP,PIT(5) - ^- -
SAN D,IOR DRAT ORAINFIELIIELIJ
1 HERCBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYVIELL Cl
AND STATE THAT THE ABOVE_ IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLUMPING AND SEWERS. ALTER,REPAIR,SEWER OR
SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANDIOR --- "- -�
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNEC'i PLUG AND
CALIFORNIA OR THAT I AAS THE LEGAL O',ti NER OF THE ABOVE ABANDON HOUSE SEWER
DESCRIBED RESIDENTIAL PROPERTY, BACKFILL SEPTIC.TANKS C -
�..e SEEP.PI'T(S) 0 CESSPOOLS'El � I_
SIGNATURE
OF PERMITTEE._
WILLIAM J.FOX,COUNTY ENGINEER VAIMATION R.A.WOOD. CHIEF PLBG. INSPECTOR