HomeMy Public PortalAbout5740 ALESSANDRO AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FCX, COUNTY ENGINEER I ADDRESS
BUILDING fD 1
FOR APPLICANV4( FILL IN LOCALITY-
BUILDING FI d DNEARESTADDRESS 'h�h�U [Jj ?F CROSSST. 1 �tVP /%/v✓'e I
LOCALITY DISTRICT NO. SERIAL NO. ' PERMIT NO. c
NEAREST / /`„ F A I 1094 —S
CROSS ST. k--"4
11 /'� �,f r/ R CEIVED BY Ready for Inspection `DATGE ISSUEDJ�
OWNER /_/ _//4�/y G ,L� C3�Gf 1 l—t -.S,4
ADDRESS j 7' Q //G, 4`X e j,_Sj j/112ef0 USE ZONE Y OCCUPANCY BK MAP PG
CITY TEL.NO.
CONTRACTOR 44rdV CU _ Y, 4<Z-,CU✓ CO.IMP.N0.
ADDRESSQ0 A 1144 JOB NO.
CITY �C�`�� TEL.NO' y -:71Y TRUNK PERMIT N0.
s STATE
REGISTRATION NO. COUNTY ROAD PERMIT NO.LEG
DESCRIPTION LOT N0. Q. ;y�t3 � STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT -;,' NO.OF BLDG§.
x NOW ON LOT' CHARGES
BUIL DINGS /3f�SiQ�/Y�'�' CONNECTIOWq.HARGE FEE
NO. DESCR PTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER @ $ 3.50 ` RECEIPT N0. A•l I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED �a
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- I DATE I BY
_SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR STATION DEPTH '
_ PITS AND/OR DRAINFIELD 2.00 [� -r-��1
CESSPOOL—DRYW ELL
2.
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
L4PizE LOWER
TYPE OF CO_ ECTION LENGTH FROM
OWNERS: PERMIT $ 1 00CURB -a,l.� M.L.TO P.L.
AUTHORIZATION I TOTAL FEE d
IE THIS DATE CONTRACTED WIT THE HEREIN NAMED
CONTRACTOR TO CONNECT THE AB V DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE P ELIC WEB sO.
SIGNED THIS._.._���...__ A ............._...' ._......IY L NEW HOUSE SEWER �p
OWNER OR � / "�'`�+ CONNECLDI DDOR WORKAL
OWNERS AG T____.-_.-.__.... __ _BU
SEPTIC TANK,SEEP.PIT(S)
ADDRESS_ ---------- . ......... ..... .. ..............'._ _.._ i AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE TH, I HAVE READ THIS APPLI- CESSPOOL� DRYWELL E
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",D SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY q AT I AM P PERLY REGISTERED
AND/OR LICENSED QUI BY NGELESC UN DISCONNECT PLUG AND
AND STATE OF CAL I I A H LEG 0 ABANDON HOUSE SEWER
ER OF THE ABO >;CLN BACKFILL SEPTIC TANKS
I SEEP.PIT(S)E] CESSPOOLS E]
SIGNATURE
OFPERMITTE ------- • ----................_ --- - -•--- --•--•-------------
76A642A 663 7/53
J �,Q