HomeMy Public PortalAbout10656 ARROWOOD ST_Sewer_4/16/1954_house sewer connecting to public sewer I
DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
FOR APPLICANT TO FILL-IN / LOCALITY
BUILDING O NEAREST ��G—
ADDRESS (p (p ��/// CROSS ST. /' /✓T
DISTRICT N0. SERIAL N0. PERMIT N0.
LOCALITYNEAREST
CROSS ST.
_RE//C E Y,!:'7 Ready for Inspection TE ISSUED'
OWNER
MAIL / — cv
ADDRESS l r USEZONE� OCCUPANCY BKG
CITY TEL.NO. `�I _ � ( z
CONTRACTOR / 1h �/) CO.IMP.NO. A ,,e
ADDRESS
_ ��L_l _.alert .pie _ JOB.N 0.
CITY �TELAO+. � u ��i TRUNK PERMIT NO.
REGISTRATION COUNTY N NO. ��_ �/ , ®p
_ ROAD PERMIT N0.
LEGAL
DESCRIPTION LOT N0.-� 2! /�/ P� � Yy� / O STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT 2--_d �� / INDUSTRIAL
WASTE APPROVAL
NO.OF BLDGS.
SIZE OF LOT I CHARGES
� NOW ON LOT
NOW
USE OF
BUILDINGS ` CONNECTION CHARGE E
NO. DESCRI ION OF WORK FEE
REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO .
PUBLICSEWER @ $ 3.50 RECEIPT NO: DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00 ,
CONNECT ADDITIONAL BLDG.OR _ EXCEPTION ECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING �0- I DA'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 2.00 STATION Z.Q DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 �' MANNUPPEFERENCE
WElfi
r ER- lzO
YPE OF CONNECTION LENGTH FROM +
$ I 00 Y <�f3 d= M.L.TO P.L.
OWNERS --�ERMIT . �y '
AUTHORIZATION I TOTAL FEEHAVE I I S
CONTRACTOTHIS
R TO CONNECT THTED WITH THE E ABOVE DESCRIBEDN NAED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS-_I_.� _DAY OF > %�z_�_�_.19 ~�r NEW HOUESSEWERi
OWNER OR '+ CONNECT ADDITIONAL
OWNERS AGENT------------_, BUILDING OR WORK
SEPTIC TANK,-SEEP.PIT(S)
ADDRESS.......-----------------•--- --.•-•---.._.....-�.-••-.-•------....._... AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E]-DRYWELL
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 AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED NNECT D--
PLUG AN -- -
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDISCODON HOUSESEWERAND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL,SEPTIC TANKS E]
SIGNATURE SEEP.PIT(S)[] CESSPOOLS'[]
OF PERMITTEE - �`t------`e--_"^----------. - -
..
7 A642 663 7/53 J K.