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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 f� FOR AP LICANT TO FILL IN LOCALITY 7efn BUILDING _ NEAREST ADDRESS /.�� CROSS ST f ) 2� >1, AAA A • v�p DISTRICT NO SERI N6o� PERMIT NO LOCALITY -.Y� - '/ � � fl A, S NEAREST n • e , _//(}�(-� CROSS ST p RECEIVEDaBV`� Ready for Inspection DATE ISSUED OWNER MAIL � r z,-yPd.it70 ADDRESS ,,„, �/7 USE ZONES I /OCCUPANCY MBK MAP PQ ClTY' .s e.ATELNO I /0/ CONTRALTO * / `3 � CO IMP NO / c ADDRESS COP,de J 'JOB NO • - - CITY TEL NO r ,p TRUNK PERMIT NO STAfE 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_ \76A642A 663 7/4 w 0 ,c r 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