HomeMy Public PortalAbout8740 WENDON ST_Sewer__ 76A6420
E-063 11-55 APPLICATION FOR PERMIT
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN', SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
LEGAL
DESCRIPTION OWNER
CRI TION LOT NO.
, — :7 MAIL
BLOCK TRACT
NO, OF BLDGS.
SIZE OF L01 NOW ON LOT s "'V4,-, No TEL.
USE OF
DISTRiCTNO. GROUP MAP
BUILDINGS
.-._�j __- QK PG
CONTRACTOR�
-
CONNECTION DATA
ADDRESS
STALl( N D
CITY P:
MANHOLE REFERENCE
STATE
REGISTRATION NO, COUNTY
NO, DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING'WhECCONNECTING0
TYPE OF CONNECT]O `,,,.P M.L� TO PL,LENGTH FROM
A .
L JPUBLIC SEWER @ $3.50
SEEPAGE- --------
SEPTIC TANK. PAGE PIT OR
PITS MND/OR DRAiNFIELD 3.0
OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. NO,
EXTN.,CESSPOOL,ORYWELL,MAN HO.LE f/__$2.00 i . .. I �- -------!9�13N9,
1-1-�---n-M - �.
HOUSE SEWER CONNECTING TO (n) $1.00 TRUNK PER NO. ROAD
PRIVATEDISPOSAL-SYSTEM ROADPERM PERMIT-N
CONNECT ADDITIONAL BLDG,OR
STATE ENCROACHMENT
WORK TO HOUSE SEWER $1.00 i PERMIT 140.
ALIER,REPAIR OR ABANDON HOUSE
INDUSTRIAL
i I SEWER--.-O
OR DISPOSAL SYSTE-M WASTE APPROVAL CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT 5 1 00
REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE APPROVALS DATE INSPECTOR'S SIGNATURE
I HAVE AT THIS DATE A.CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT I"HE ABOVE DESCRIBE[) EXISTING DWELLING
TO THE PUBLIC SEW NEW HOUSE SEWER
SIGNED THIS ,—19---LZ CONNECT ADDITIONAL
OWNER OR
BUILDING OR WORK
OWNERS AGEN
SEPTIC TANK,SEEP,PIS)
ADDRE
ANDIOR DRAI�FIELD
-i,414
-d,
I HEREBY ACKN; IEDf;g THAT I HAVE READ THIS APPLICATION CESSPOOL ' DRYWELLF-I
ANL) STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLURBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY IHAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED W
By LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEER
CALIFORNIA OR THAT I M, THE LEr,k"WNER OF THE ABOVE
DESCRIBED RESIDENTIA ROPERTY�,� BACKFILL SEPTIC TANKS
SIGNATURE L,SEEP. PIT(s) Lj CESSPOOLS
OF PERMIT
1OHN A. LAMBIEbUNTY ENGINEER VALIDATION ROBERT A. WOOL),CHIEF PLBG. INSPECTOR
M.Q� CASH
i&E-6-6663 19.55 APPLICATION FOR PERMIT 1
5&
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County.of Los Angeles BUILDING
JOHN A. LAMBIE,COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN, SUPT Or BUILDING LOCALITY ;Y -
NEAREST
- FOR APPLICANT TO FILL IN _CROSS;ST.ALEGAL
, }
DESCRIPTION LOT NO 5fq/; �'i a - • ,�: OWNER
BLOCK TRACT '✓- MAIL ..i
---------------- _ _ ADDRESS _ 'Y`L: f�
NO. OF BLDGS.
SIZE OF LU_T--- - -- NOW ON LOT_ P� CITY �' TEL. NO. 5 ' .
USE OF
_BUILDINGS DISTRICT NO. I GROUP MAP
-- — _ PG
CONTRACTOR
ADDRESS '�. N A ..--- —
CONNECTION DATA
CITY TEL. NO:. ', k� T` ION �. ';;ay;_ - DEPTH
r" MANHOLE REFERENCE,;
-Er-STATE
REGISTRATION N0, COUNTY ,-
No. l DESCRIPTION Or WORK PEE
-— --- --- — TYPE OF CONNECTION LENGTH FROM
HOUSE SEWER CONNECTING TO
I - 1 �I Y. CURB P.L. M L TO P L.
, i PUBLIC SEWER C $3.
- 6 - --.
i SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFILLD a $3.00
----� - "-
OVcRF'LOW SEEP-AA_GE PIT,DRA[NFIE:LD � P C h0
. C6,
EXTN_CESSPOOL,DRYW LL MANHOLE Cq_ $ 2.Ofl-_-__-� CO. IMP. NO. _ JOB NO.
HOUSE SEWER CONNECTING TO !! -
PRIVATE DISPOSAL SYSTEM W $1.00 I 1 TRUNK PERMIT NO. - - ROAD PERMIT NOV.
TO HOUSE
I WORCONNECT ADDITIONAL BLDG..OR - �
"Y. Pu, I STATE ENCROACHMENT .✓
_..i .- ---- -----SEWER------------- -$7_00_%—_-----I - - PERMIT'NO,
I ALTER,REPAIR OR ABANDON HOUSE — -- --_ --_- ----__---
SEW'ER OR DISPOSAL SYSTEM (i. 9.00 I INDUSTRIAL
- _. -_ _.--_ �..._- WASTE APPROVAL
I 5_ � , 1
�. -��--- �.— CHARGES
CONNECTION CHARGE FEE -
t
OWNER'S PERMIT � � ---- - - --- -----�_._.
REIMRURSEMENT FEE
AUTHORIZATION TOTAL FEE - - a
W APPROVALS DATE (INSPECTOR'S SIGNATURE
F HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO
ON•TRACT'CR-TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -
TO THE PUBLIC SEWER. NEW HOUSE SEWER
SIGNED THIS---DAY OF 19—._ CONNECT ADDITIONAL - �- -----�---
OWNER OR BUILDING OR'WORK
OWNERS AGENT --- --
'-'--`-I V �, SEPTIC TANK,SEEP PIT
ADDRESS—.-- AND/OR DRAINFIE.LD ,
I HEREBY ACK OW EDGE THAT I HAV:L READ THIS APPLICATION CESSPOOL[]. DRYWELLLj
AND STATE :N i THE ABOVE 11 CORRECT AND AGREE TO COMPLY _-.-_-_ __-_-- _-._-�_—�__--- _---._-.----._----
THa sLL C)�CJ� Y ^.•R utNAN CES AN➢ STATE LAWS REGULA.iNG ALTER REPAIR,SEI�'ER OR -
LUi']Bf aG AND SEVWERS- SEWAGE DISPOSAL SYSTEM ,
I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND OISCC
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCON HOUSE SEWER —I
CALIFORNIA OR THAT' I A THE LEGAL NF.Fk OF THE ABOVE I-----------------"--
DESCRIBED REIDENTI
., ,4L P PERTY. BACKFILL SEPTIC TANKS❑
SIGNATURE
i•`,� - SEEP PITS) J CESSPOOLS
� --- - -- -f- - ---
OFPERMITTE i ;'
d F
JOHN A. LAMBIE, CO TY ENGINEERV6iL11< iTION ROBERT A.WOOL), CHIEF PLBG. INSPECTOR
CY.�_' N.O. CASH
f.,