HomeMy Public PortalAbout5335 ZADELL AVE_Sewer_6/23/1967_CONNECTION TO PUBLIC SEWER (2) E
Sa ,6es 11.�s APPLICATION FOR PERMIT-,
S a>r�s
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUtLDtxr
JOHN A. LAMBI ,, COUNTY ENGINEER ADDREss--� � �:r ���✓)y
GASSATT D. GRIFFIN, SUP'T OF 13UILDING LOCALITY s
NEAREST
_-- ---FGR APPLICANT TO FILL IN CROSS ST, -
LEGAL =
DESCRIPTION LOT NO. tui OWNER � m �r, 411
1fIAIl
BLOCK TRACT a�� nDDRESS
NO.OF BLDGS. UI"fY�- TEL. NO. i
SIDE OF LOT NOW ON LOT ,y?-- t?"`
USE OF �r �;...,. DISTRICT N0: I GROUP %AP
BUILDINGS ' r - BK PC
CONTRACTORADDRESS 4 E --- --- __T----
?f --- CONNECTION DATA
STATION DEPTH
' A
CITY ,gr ';.�.;,, 'TEL. 0. - y �,�.�,,,�`, w•.:• __.—.__ __._..
---+'>rE .:a'-- b{•'" �-49: ----.. .. _'__s. __ MANHOLE.REFERENCE
STATE _ LOWER
REGISTRATION No.. r, [j COUNTY
NO.. DESCRIPTION OF WORK PEE
-..__... -------.—_.�__ ._.._.._-...�.-.,— TYPE OF CONNECTION LENGTH FROM
HOUSE SEWER CONNECTINGTO
PJ6LIC SEWER I 3 ; � Y CURB^ P.Lv M.L- TO P.L.
_..,._.,. -------...._
2l $3.50 r 3 _..-._.._.. ._.—___-- _
SEP'TIC'fANK,5EEPAGI:PI'T OR
PITS AND/OR DRAINF ELD Jz $3.00 ---.-.,.-_�s_--------_---_.---T-----__.—
OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. NO. -
EXTN.,,ESSPOOL,DRY4WELL,14AFdHa `$OLE + 2.081 CO. imp. N0, JOB NO.
i HOUSE SEWER CONNECTING TO ----— 1 - T _ ---- ----
�_PRIVATE
DISPOSALSYSTEM C `'i 1.00 �. _TRUNK PERMIT N0, ROAD PERMIT N0.
- --_.___-------.._--- -----------.-.----. _._
CONNECT ADDITIONAL BLDG.OR --- -- STATE ENCROACHMENT
WORK T4? HOUSES EWER C `b".00 PERM,T NO.
I ALTER,REP TR CR ABANCO?r HOUSE INDUSTRIAL
! SEWER OR DISPOSAL SYSTEM .... -._ (c $1.00 WASTE APPROVAL
CHARGES
..— —.._._- ------ _-.___._._ CONNECTION CHARGE FEE
OWNER'S PERMITD I OtJ
i �
REI M.2URSL�'MENT FEE
AUTHORIZATION �®IAL SEE � I��
I HAVE Ar THIS DATE A CONTRACT hiT}, kt HEREIN NAMED CON- APPROVALS i DATE N5?ECTOP 5ti'GNA r U R E
_ _ _- -' ----- -._.-
TRACTOR TO GCNNFCT THE AFOVE DESCRIBED EXISTING DWELLING 7_ _- -
TO THE SE:';iErt• NEW HOUSE SEWER
SIGNED 7k15_-----Dr IONN CT ADDlTIONAi j
OWNER OR .,. UI.LD NG OR V OeK---.__ ---------
OWNERS Aa'r:NT, z-. �. '' .P.Y'.� d - _----..
ADDRESS,._ —__. ___ TNiL'Cf` Dry,tilP!''1LLU
I HERESY A(:KN10;,'t,ED,-,F THAT I HAVE READ 'T HIS APPLICATION CESSPOOL. ; DRYWELLO
AND STATE THAT THE ABOVE IS CORRECT AND AG6£E TO COMPLY
WiTH ALL COON-f l ORDINANCES' AND STATE LAV15 REGULATING ALTER,REPAIR,SEWER OR 1
PLUMBING -AND StUVERS SEWAGE DISPOSAL SYSTEM I
I HERE'S CERTIF'I l AT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED ,ASREQUIRrD By LCS ANGELES COUNTY AND SLATE OF �
ABANDON HOUSE SEWER
CALIFORNIA CZ' lhi T MTHE LEG,At-)TOWNER OF THE ABOVE -
DESCR EFD R?:: IDENTIA.Ir'I'ROPERTY '. +' BACK ILL SEPTIC TANKS Dj
CESSPOOLS
SEEP. PIT(5.1 �i SSPO L
SICNATCRF. ' ,•''� .fi'-' ,/� ., _... ... _- "---
OF PERMITTEE ---
JOHN A. LAMBIE, CpCINTY ENGINEER VALIDATION ROBERT A.WOOD. CHIEF PLEG. iNSP CTOR
y CK. M. c. C'A^»