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Home My Public Portal About9549 GIDLEY ST_Sewer_9/13/1954_6 & &-663 12-54 APPLICATION FOR PERMIT 6 & E•66 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County Engineer County of Loa Angeles BUILDING kolry ADDRESS WM. J. FOX, COUNTY ENGINEER JCASSATT O. GRIFFIN, SUPT OF HOICGING LOCALITY /il/•,J,/._FOR APPLICANT TO FYLL IN CROSS ST /!� f' &l it LEGAL DESCRIPTION LOT NO. _ OWNER BLOCK TRACT 1h? 9 �� MAID yl, �� ADDRESS_ �r/l J • NO. OF BLDGS. �f !� SIZE OF L0�( ! -dvo,�,NOW ON LOT CITY ViAA/VLIAA TEL. NO. �Z), S % USE OF BUILDINGS-..a�,,Z:r..� , /,alr-+w-��•�` CONTRACTOR ADDRESSS�'Y 4 F a/u .✓ CITY r.,a.t;�v�.ta V TEL. N0, ,P` ❑ STATE REGISTRATION NO. ❑ COUNTY NO, DESCRIPTION OF WORK FEE HORSE SEWER CONNECTING TO _PUBLIC SEWER _ _ �_+_$ 3.50 , HOUSE SEWER CONNECTING TO PRIVATE DISPCSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.130 SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DRAT NFIELD 2.00 CESSPOOL - DRYWELL SPECIAL CONDITIONS ONLY 2.00 OWNER`S PERMT S t 00 AUTHORIZATION TOTAL FEE =— ',1 i HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER SIGNED THIG nAY OF 19 OWNER OR OWNERS AGENT ADORv I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AK PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE �' ��l— OF PERMITTE DISTRICT Ng. I GROUP MAP BK PG CONNECTION DATA STATION �� •� ;� l 7 %, DEPTH G ' MANHAZ REP2kENCE/ % _ JJJ'PEA� (. '• f-/ .k / LOWER TYPE OECTION LENGTH FROM Y. CURB P. L, Id. L. TO P. L. •,� CO. IMP. NO. (� TRUNK PERMIT NO. STATE ENCROACHMENT PERMIT NO. J03. N0, ROAD PERMiT NO. INDUSTRIAL WASTE APPROVAL. CHAR(G5 CONNECTION CHARGE FEE REIMBURSEMENT FEE` APPROVALS DATE NEW HOUSE SEWER` CONNECT ADDITIONAL BUILDING OR WORK SEPTIC TANK, SEEP, PIT(5) AND/OR DRAINFIELD CESSPOOL ❑ DRYWELL ❑ ALTER, REPAIR, SEWER OR SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND ABANDON HOUSE SEWER BACKFILL SEPTIC TANKS ❑ SEEP. PIT (S) ❑ CESSPOOLS Cl t INSPECTOR'S SIGNATURE WILLIAM J. FOX, COUNTY ENGINEER VALIDATION 45 6 BY BY DEPUTY DEPUTE —4-' BY BY• © DEPUTY - DEPUTY