HomeMy Public PortalAbout9878 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
CASSATT D. GRIFFIN, SUPT OF BUILDING ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS CROSS S7.
LOCALITY /- DISTRICT NO. A SERIAL NO. PERMIT NO.
NEAREST
CROSS ST _ RECEIVED BY Ready for Inspection DATE ISSUED
n
OWNER
MAIL / USE ZONE OCCUPANCY ( MAP
ADDRESS f �=-rk r.begf � ,_ BK PG
CITY fY TEL NO. C:, a
s
CONTRACTOR CHARGES REIMBURSEMENT FEE
ADDRESS
REQUIRED
--
NOT REQUIRED
CITY TELAO. SOB NO. CONNECTION CHARGE FEE
-
STATE CO.IMP. N0.
REGISTRATION N0. COUNTY
LEGAL 0. RECEIPT NO. DATE BY
DESCRIPTION LOT Nf 7
BLOCK TRACT _ -- WAIVER FOR RECORDING
SIZE OF LOT . NO.OF BLDGS_ RECEIPT NO. DATE {{BY
'.`' NOW ON LOT I
USE OF �_�:;� :
BUILDINGS ?_` 2-" TRUNK PERMIT NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ROAD PERMIT NO.
PUBLIC SEWER @ $ 3.50 STATE ENCROACHMENT
HOUSE SEWER CONNECTING TO PERMIT NO.
PRIVATEDISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR INDUSTRIAL
WORK TO HOUSE SEWER 1.00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00 I CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 { STATION DEPTH
SEPTIC TANK,SEEPAGE PIT OR -
_ PITS AND/ORORAINFIELD 2.00 I MANHOLE REFERENCE
CESSPOOL—ORYWELL UPPER -" LOWER
SPECIAL CONDITIONS ONLY 2.00 TYPE OF CONNECTION LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERS PERMIT $ I 1 00 —
AUTHORIZATION TOTAL FEE I
ED
CO TRACTOR HAVE THIS TO CONNECT THATE TE ABOVE DESCRIBED ED WITH THE t EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS------ t, ,,::DAY OF, NEW HOUSE sEwER I �_
14
OWNER OR t -� CONNECT ADDITIONAL
r ,;� � - BUILDING OR WORK
OWNERS AGENT ..rfv:` -.. 4`y ............. - SEPTIC TANK,SEEP.PIT(S)
ADDRESS. ---------------------------•-- AND/OR DRAINFIELD
t HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
70 COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER
REGULATING PLUMBING AND SEWERS. _SEWAGE DISPOSAL SYSTEM _
I 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 I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)o CESSPOOLS 0
OF PERMITTEE.-__------------ - ------- ...... - -
76AG42D 663 12/€2