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HomeMy Public PortalAbout9867 WENDON ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER--SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS FOR APPLICANT TO FILL IN LOCALITY BUILDING NEAREST ADDRESS �. CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT N0,97 r NEAREST S CROSS ST. 2— RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL OCCUPANCY USE TONE ADDRESS � BK MAPPG CITY TEL.NO. CONTRACTOR CO.IMP.NO. ADDRESS JOB.NO. CITY T£L.NO. TRUNK PERMIT NO. STATE REGISTRATION N0. LU7i'i Y ROAD PERMIT N0, LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT PERMIT NO. BLOCK TRACT INDUSTRIAL - WASTE APPROVAL SIZE OF LOT NO.OF BLDGS. NOW ON LOT _ CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER _ j 3.50 RECEIPT NO. ( DATE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 NO. f DATE )BY ALTER OR REPAIR EXISTING 11 SEWER OR DISPOSAL SYSTEM 1.00 DtSCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LUW Ets TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT ! 00 Y. CURB P.L. M.L.TO P.L. ; ! AUTHORIZATION I TOTAL FEE 1 I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOWSSIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS................_..DAY OF_............................._......19....... NEW HOUSE SEWER ` OWNER OR CONNECT ADDITIONAL OWNERS AGENT...................................................__......_......_...._.. BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS__.----._.-------._.....-.•-------.-..--..................................-.... AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL I] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 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 1 AM THE LEGAL OWN- ER OF THE ABOVE.DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SEEP.PIT(S)E] CESSPOOLS© SIGNATURE OF PERMITTEE_ ----- ....-..... ...........-------- 76A642D 663 1/53