HomeMy Public PortalAbout6155 AVON AVE_Sewer__ DFPARTDIENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
✓`-MWSION OF BUILDING AND SAFETY PERMIT APPLICATION
t�L COUNTY OF LOS ANGELES
WILLIAM J FOX, COUNTY ENGADDREINEER BUILDISSNG 1
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FOR AP LICANT TO FILL IN LOCALITY 7efn
BUILDING _ NEAREST
ADDRESS /.�� CROSS ST f ) 2� >1, AAA
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• v�p DISTRICT NO SERI N6o� PERMIT NO
LOCALITY -.Y� - '/ � � fl A, S
NEAREST n • e , _//(}�(-�
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RECEIVEDaBV`� Ready for Inspection DATE ISSUED
OWNER
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CO IMP NO / c
ADDRESS COP,de J 'JOB NO • - -
CITY TEL NO r ,p TRUNK PERMIT NO
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REGISTRATION NO FCOUNTV
ROAD PERMIT NO
LEGALSTATE ENCROACHMENT
DESCRIPTION LOT NO PERMIT NO
BLOCK --- TRACT `� �� INDUSTRIAL
(WASTE APPROVAL
SIZE OF LOT NO OF BLDGS 'F�
NOW ON LOT t.� CHARGES
USE OF �7 •
BUILDINGS P- f CONNECTION CHARGE FE `
NO DEOCRIPTION OF WO K FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLICSEWER $ 350 RECEIPT NODATE IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1 00
CONNECT ADDITIONAL BLDG ORe EXC�FPTI RECORDED
A TO HOUSE SEWER 100 N I"
ALTER OR REPAIR EXISTING P I ATE BY
SEWER OR DISPOSAL SYSTEM 1 00
DISCONNECT AND ABANDON SEWER a /
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
_ PITS AND/OR DRAINFIELD 200 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 200 MAN LE REFERENCE
P ER LOWER
TYPE OF CONNEC ON LENGTH FROM
Y CURB PL ML TOPL
OWNERS I PERMIT $ I 1 00
AUTHORIZATION I TOTAL FEE I,;-> leV.6
IHAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED dl J
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS __ DAY OF 19_.__ NEW HOUSE SEWER
OWNER OR BUILDING ORNECT WORK
OWNERS AGENT _ _ _ _ _ _ _ _ _ _ _ _ 7�
SEPTIC TANK SEEP PIT(S)
ADDRESS AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI I CESSPOOL F] DRYWELL C]
CATIONAND STATE THAT THE ABOVE 18 CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWER OR
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 D CRIBED R IDENTIAL PROPERTY BACKFILL SEPTIC TANKS O
SIGNATURE SEEP PIT(S)[] CESSPOOLS❑
OFPERMITTE n -�' �* _ M=y 'mob_
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5 66 1155 APPLICATION FOR PERMIT 1
DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Deportment of County Engmeer
County of Los Angeles BUILDING r
JOHN A LAMBIE COUNTY ENGINEER ADDRESS +
® CAS�SATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NeR REsr
DESCRAL IPTION.IPTION LOT NO ^° 3 MAIL /� 'ay/��, �yiy
_ V 47 17 3 i MAIL (! 1���� /,; ee,/Z J
BLOCK TRACT ADDRESS
NO OF BLDGS yl,� C TEL NO
SIZE OF LOT NOW ON LOT V
USE OF DISTRICT NO G MAP
BUILDINGS BK PG
r
CONTRACTOR i �``4� *� t� �!^ {J
ADDRESS
CONNECTION DATA
f L ��� �lF,.'(' 1 ry i f �j,
47 5°1 STATION DEPTH
CITY TEL NO
MANHOLE REFERENCEUPPER
ESTATE �+ LOWER
REGISTRATION NO ❑ COUNTY / ,P
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM
Y CURB PL ML TOPL
PUBLIC SEWER @ $3 50
SEPTIC TANK SEEPAGE PIT OR rAD wv� a, i/ :1.k
PITS AND/OR DRAINFIELD Q $3 00 � /'%F /� �9/ , d^
OVERFLOW SEEPAGE PIT DRAINFIELD P C NO
EXTN CESSPOOL DRYWELL MANHOLE Q $ 2 00 CO IMP NO JOB NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO ROAD PERMIT NO
CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT
WORK TO HOUSE SEWER Q $1 00 PERMIT NO
ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM Q $1 00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER S PERMIT g 1 00
REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE 31dv
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMEDCON APPROVALS DATE INSPECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL 'L
OWNER OR �� ✓yn BUILDING OR WORK
�.
OWNERS AGENTX� ` ' SEPTICTANK SEEP PIT(S)
ADDRESS AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER OR
PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON CT PLUG AND
CALIFORNIA OR THAT I THE LEGA WNER OF THE ABOVE
HOUSE SEWER
DESCRIBED RESIDENTIA OPERTY BACKFILL SEPTIC TANKS❑
SEEP PIT(S) ❑ CESSPOOLS
SIGNATURE ❑
OF PERMITTEE 1
JOHN A LAMBIE 06UNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
�K1 5 7 9 7c° MAY ,�, 4 T Q C �
rr
DEPAlCfAMff OF COUNW ENGINEER SEWER-SEWAGE DISPOSAL 1
. 4'DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J FOX COUNTY ENGINEERI ADORENG�/ref
ADDRESS `
FOR APPLICANT TO FILL IN LOCALITY 7NE
BUILDING
ADDRESS -�J=.,,ZJ��� AREST
CROSS ST
LOCALITY • DISTRICyCTTrNO- SERIAL NO PERMIT NO
NEAREST ,�` �! A '�'i��" S
CROSS ST
RECEIV B Ready for Inspection ;0AMAIL I TE UED
OWNER D
ADDRESS U E ZON OCCUPANCY
BK PG
CIT TEL NOdFF
/1 /
CONTRACTOR - CO IMP NO
ADDRESS JOB NO
Cl, TEL N%4%Gr TRUNK PERMIT NO
STATE
yF��
REGISTRATION NO COUNTY ROAD PERMIT NO 2— 41 1 ,?5—
LEGAL
DESCRIPTION LOT NO _ �� STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT . INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT y NO OF BLDGS
�l 102 a NOW ON LOT CHARGES
USE OF
BUILDINGS �( �,y„, �yg� CONNECTION CHARGE FE 4
NO DESCRIPTION OF WOOK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER @ $ 350 RECEIPT NOI DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1 00
CONNECT ADDITIONAL BLDG OR E EPTIO RECORDED
WORK TO HOUSE SEWER 1 00
ALTER OR REPAIR EXISTING NO I DV 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
PITS AND/OR DRAINFIELD 200 STATION 2'_L O� DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 200 A UPP FERENCW
1000 TYPE OFlimpCU ECTION LENGTH FROM -
OWNERS PERMIT- ; CtAy M L TO P L le
AUTHORIZATION TOTAL FEE 50
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTORS SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED TH,sp?3 DAY OF _ I NEW HOUSE SEWER
OWNER OR 1' CONNECT ADDITIONAL 3
OWNERS AGENT �- - - _ _ BUILDING OR WORK
�- SEPTIC TANK SEEP PITS)
ADDRESS - - AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE f
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWER OR �1
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN
ER OF THE ABOVE D CRIBED R IDENTI L PRO RTY BACKFILL SEPTIC TANKS
SIGNATURE SEEP PIT(S)[] CESSPOOLS[]
OF PERMITTEE
70A042D 663 1/53