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HomeMy Public PortalAbout9445 LAS TUNAS DR_Sewer_10/8/1974_connect sewer 76A 642D—'CE8d8=10-71 APPLICAT NFOR PERMIT COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER _ BUILDING AND SAFETY DIVISION FA LDING ADDRESS LITY i REST FOR APPLICANT TO FILL IN SS ST. LEGAL D ESCR IPTION .LOT NO. �-" OWNER MAIL BLOCK TRACT ADDRESS NO. OF SLOGS. SIZE OF LOT - NOW ON LOT / - C IT YLvzfy ,� ��T TEL. NO. USE OF BUILDINGS ' DISTRICT N GROUP - MAP "OCESSED BY - /BK PS CONTRACTOR C/./�,�j�.�� •"D� !� I � \ ADDRESS -.d• CONNECTION DATA STATION 7 C/ DEPTH CITY, P, f TEL. STATE 2~ �`"-yj^ LIC MANHOLE REFERENCE //{� 7 UPPER LICENSE NO:: �. GLASS / �(/✓�3 7/ - NO. DESCRIPTION OF WORK FEE - TYPE OF CONNECTION LENGTH FROMi HOUSE SEWER CONNECTING TO Y. CURB P1L M.L.TO P.L. PUBLIC SEWER @ $7.00 SEPTIC TANK.SEEPAGE PIT OR JOB NO. PITS AND/OR DRAINFIELD @ $10.00 CO.IMP. NO. .108 NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 O CONNECT AkXD T+ NAL_BLDG.OR AFFIDAVIT WA '-EASEMENT R IVER ECORD.INSTR.NO. . DATE U WORK TO HOUSE SEWER @ $3.00 Ori . OVERFLOW SEEPAGE PIT.DRAINFIELD Ing EXTN..CESSPOOL.DRYWELL.' @ $5.00 HWY.OR ST.WIDENING O ALTER.REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT W @ $7.00 MANHOLE PERMIT NO. a N INDUSTRIAL ' WASTE APPROVAL Z OWNERS 'PERMIT S 31 00 CHARGES AUTHORIZATION TOTAL FEE ©d CONNECTION CHARGE FEE IHAVE AT THIS DATE,A.CONTRACT WITH THE`HE-�PIETN,\NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE.DESCRIBED EXISTING DWELLING TO THE PUBLIC S,.� '^y���' - - APPR_ OVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS -DAY OF f 19 _ OWNER OR �i./ /j��. (' NEW HOUSE SEWER OWNERS AGENT OOO �! L� - CONNECT ADDITIONAL t` « e•1 / BUILDING OR WORK ADDRES 4! I HEREBY ACKNOWLEDGE THAT I HAVE READ_THIS APPLICATION SEPTIC TANK.SEEP,P17(S) - AND/OR DRAINFIELD AND STATE THAT THE ABOVE-IS--CORRECT-AND-AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER, REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES NTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA ORT I AM T LEG ER OF.'_AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE B E IBE ,IJDENTI PROPERTY. ABANDON HOUSE SEWER SIOF ATURE PERMfTT Loty'L % BACKFILL SEPTIC TANKS ❑ - SEEP.PIT(S) y- vESSPOOLS ❑ 7/0" VALIDATION (CK.' M,.O: CASH i