HomeMy Public PortalAbout8741 WENDON ST_Sewer__ �6A -66
E•669 t1.88 APPLICATION FOR PERMIT 1
i&E
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 OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN _doss sr.LEGAL
DESCRIPTION LOT NO. "4 -'` �• X>' 1 ;,1 ~OWNER -- --- —�
MAIL
BLOCK TRACT ADDRESS ---_----
'� NO, OF BLDGS. ry
CITY f _ TEL. NO.
_SIZE OF LO_T .. •,,, s-,__ NCW ON LOT -"
USE OF
_BUILDINCS _ - —i DISTRICT NO, GROUP MAP
BK PG
CONTRACTOR
CONNECTION DATA
ADDRESS — -- - _-
STATION DEPTH
CITY i EL,NO, --- -.— .�_L.'•-------- ----__.
. ------. --- MANHOLE REFERENCE _`brPER.-
_---.. STATE ------------ -- — --- .LOWER.--
REGISTRATION-'N0. _ +:� ❑ COUNTY
No DESCRIPTION OF WORK FEE ---------- ---------------- --.—__... _
i HOUSE SEWER CONNECTING TO — -- TYPE OF CONNECTION LENGTH FROM. ..
_ PUBLIC SEWER @ $3.50 i Y• CURB P.L. M.L, TO P.L.
SEPTICSEEPACs PIT OR
17S AN /OC(t $3.00
FJ — —
I——D D R---DRAINFI£LD— -- -- — — P C N 0
! OVERFLOW SEEPAGE PIT, CRAI AFIELD
EXTN.,CESSPOOL,DRYFELL,MANHOLE 01 $2.00.1. _.-0-. IMP. NO- ---JOB NO. — - —
HOUSE SEWER CONNECTING TO -
PRIVATE DISPOSAL SYSTEM _ _(a. $1.00_j. ! TRUNK PERMIT NO. ROAD PERMIT NO. y s' r
CONNECT ADDITIONAL BLDG.OR f STATE ENCROACHMENT -
WORK TO HOUSE SEWER fit $I.00 I I PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE -- - - -----_� - ---- —!---- ---
EWER OR DISPOSAL SYSTEM <i S.00 ! #NDUSTRIAL
�- $ -__-- I. _----- WASTE APPROVAL
CHARGES -
j` - --. -- --- —. CONNECTION CHARGE FEE
OWNER'S PEFtMIT _�' 1� 00 ----�_—. .---------
..--PER T REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE
1 HAVE AT THIS DATE.A CONTRACT WITH THE HEREINNAMED CON- _APPROVALS DATE 4INSPECTOR'SSIGNAFUR.E
r --i - ---
TRACTOR 70 CONNECT THE ABOVE DESCRIBED- EXISTING DUELLING
' TO THE PUBLIC SEW 49R', NEW HOUSE SEWER
SIGNED THISDAY,gF = i8
CONNECT ADDITIONAL
OWNER OR-':
Rv 1 ,,� ✓'• "r BUILDING OR WORK
-_
OWNERS AGENT'' SEPTIC TANK,SEEP,YITt5)
ADDRESS_ i�ND/ORDnAtNFIELD
_. .�__ —.— "-_--.-_--_ --
I HEREBY ACKNOWLEDGE THAT I HEAVE READ THIS APPLICATION -
CESSPOOi[� DRYW ELL❑
AND STATE THAT THE ABODE IS CORRECT AND AGREE 70 COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 4LTER,REEPAIR SEWER OR
PLUMING AND SELVERS, __.-SEWAGE-DISPOSAL.SY_STEM___�____
I HEREBY CERTIFY THAT I AM PROPERLY REGIS'[ERED ANDlOR DISCO— " --
AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABAND 14HOUSECT SEWE s I
CALIFORNIA_ OR THAT i AM THE LEGAL OWNER OF THE :ABOVE ABANDO1d NOUS SEWER
DESCRIBED RESIDENTIAL PROPERTY. PACKFILL
SIGNATURE - CESSPOOLS
OF RMI TEE_ '
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
CK.. ffi_0. CASH _ _