Loading...
HomeMy Public PortalAbout4802 ALESSANDRO AVE_Sewer_4/22/1960_garage E808 C2aPPLICATION FOR PERMIT eeoe a Beea COUNTY OF LOS ANGELES �. SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING BUMDING AND SAFETY DMSION ADDRESS ©L4"l JOHN A LAMBIE County Fmgmeer CASSATT D GRIFFIN Sup t of Building LOCALITY ` NEAREST cz FOR APPLICANT TO FILL IN ceoss ST LEL DESCR PTION LOT NO OWNER BLOCK TRACT / MA[L ADDRESS NO OF BLDGS �J J SIZE OF LOT NOW ON LOT i[i CITY TEL NO / USE OF ��) BUILDINGS !{! Q FEGROUP MAP PROCESSED BY ` K P6 CONTRACTOR ADDRESS G C CTION DATA CITY > TEL NO DEPTH [� STATE RENCE UPPER REGISTRATION NO 0.5 COUNTY LOWER No DESCRIPTION OF WORK FEE VP HOUSE SEWER CONNECTING TO PUBLIC SEWER Q $S 00 CONNECTION ENGTH FROM PIETS AND%OR DRAEINFGIELD T OR Q $S 00 CURB P L M L TO P L OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE $200 HOUSE SEWER PRIVATE DSPOSAL SN_ETTIM TO $t 00 OB N00 CONNECT ADDITION G OR TRUNK PERMIT NO ROAD PERMIT NO WORK TO HOUSE SE 00 ALTER REPAIR OR ABANDON HOUSTATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM Q $1 00 PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNEF17S PWM $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE0L REIMBURSEMENT FEE I LS HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVADATE INSPECTOR S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESC 1BED EXISTI G DWELLING TO THE PUB LFC Ell/j SIGNED THIS j�, AY 0 9 NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS A ) BUILDING OR WORK iy T SEPTIC TANK SEEP PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGI RED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED, LOS ANGELES COU AND STATEQF ABANDON HOUSE SEWER CALIFORNIA OR THA AM THE A 0 ER OF THE VE DESCRIBED RESIDEN L PROPER BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) ❑ CESSPOOLS❑ OF PERMIT ®r6xkMATiON ROBERT A WOOD " A& Id 0. cmX SUPERVISING MECHANICAL ENGINEER LACo 9 7,4-4 ITR 72 1 0-A 3.00