HomeMy Public PortalAbout9855 WENDON ST_Sewer__ 78As4.8 APPLICATION FOR PERMIT 1
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, County, Fmgia®®r s
CASSATT.D. GRIFFIN,Sup'#of Building LOCALITY '
FNEAREST
FOR APPLICANT TO PTCI. IN. CROSS ST.
LEGAL
DESCRLPTION LOT N0. #` Y"IY � � OWNER
BLOCK TRACT MAIL
ADDRESS 3 t_ e ;e (�1✓ a
NO.OF BLDGS. y?
SIZE OF LOT NOW ON LOT j~_ CITY . i
TEL.N0.
USE OFA '
BUILDINGS �,,, t y +� v DISTRICT NO. GROUP I MAP PROCESSED BY
BK PG
CONTRACTOR —
ADDRESS
�< _�,. CONNECTION DATA
CITY TEL:N0, STATION n . � r, DEPTHr
�+ �! + �✓° STATE MANHOLE REFERENCE �h UPPER
REGISTRATION ft0, a 8 COUNTY R .•
_ _ —
rrO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ,y
PUBLIC SEWER @ $8.00 TYPE OFC CTION LENGTH FROM
SEPTIC
AND/ORD SEEPAGE
T OR @ $9,00 Y. C RB\ P.L. M,L.TO P.L. '�P
OVERFLOW SEEPAGE PIT, DRAINFIELD -
EXTN„CE_SSPOOL,DRYWELL,MANHOLE @ $2.00
HOUSE. SEWER CONNECTING TOP.C,NO.
PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP.NO. ,`n ,` Q, JOB N0.
CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT N0. ROAD PERMIT NO
WORK TO HOUSE SEWER @ $1.00 — r
ALTER,REPAIR OR ABANDONHOUSE STATE ENCROACHMENT
SEWER OR DISPOSAL SYSTEM @ $1.00 _PERMIT NO.
INDUSTRIAL
WASTE APPROVAL
CHARGES
OVVNER`S PERMIT $ 2 00 CONNECTION CHARGE FEE —
AUTHORIZATION I TOTAL FEE —REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEiOfER.>
SIGNED THIS AY OFr_} �i�t.eT_t �Q� NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT BUILDING OR WORK
SEPTIC TANK,SEEP.D PITS?
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAiNFI£L
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO-COMPLY CESSPOOL Q DRYWELL 0
WITH ALL, COUNTY ORDINANCES AND STATE LAWS,RtGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY GISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REOUIRE7y'�BY LOS ANGEL AT AND STATE,OF ABANDON HOUSE SEWER _
CALIFORNIA OR THAr�I AM THE LEG 6 HER F THE AAOVE
DESCRIBED RESIDER PROPERTY, BACKFILL SEPTIC TANKS❑
SIGNATURE CESSPOOLS
SEEP.PIT(S}
OF PERMIT
ROBERT A.WOOD
SIC H.Q. emit
LIDATION SUPERVISING MECHANICAL ENGINEER
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