HomeMy Public PortalAbout6346 BARELA AVE_Sewer__ Amos it-a7 APPLICATION FOR PERMIT
COST OF LOS ANGM.ES SEWER—SENAGE DISPOSAL
DEPaaTnExT OF COUMY ENS
BUMDMG AND SAFETY DriMOH BUIIAInG
JOHN A. LAMM ADDRtff
CAMM D. 927FIZ� LOCALITY
FOg APPLICANT—TO � NEAREST
LEGAL
DESCRIPTIOM LOT NO. / OWNER
BLOCK TRACT iM L
ADDRESS
S�`yl not ON LOFTBLDGSCm [o
SIZE OF IAT _
USE OF
BUIUING9 DIBTRICT NO. GROUP TAP
COXTQACTO r� K G
ADDRESS CONKS ION DATA
CITY TEL M0. '} STATION r DEPTH I
MHOLE REFERENC[
REGISTRATION Ito. ''¢ CoU TAN
T
NO DESCRIPTIONFHE
HOUSsE■ER COPINfICTING To
PUBLI SEWER TYPE OF CONAHCTIO LENGTH FRO[
SEPTIC YANK,SEEPAGE PIT OR T. CURB P.L M.L TO P.L
PITD AN OR DRAINFIELD 5.00
OVERFLOW a AG PIT,DRAIN LD
EITN. CESSP00 DRTWHLL YANHOLB 2.00
HOUSE SEVER CONNECTING To P. C.N0.
PRIVATE DISPOSAL SYSTEM 41 #I.DD CO 1[P 110. .TOB NO.
CONNECT ADDITIONAL BLDG.OR
WORK TO HOUSE SEWER 1.00 TRUMK PERMIT NO. ROAD PERMIT No.
ALTER,REPAIR OR ABANDON HOUSE
SEW ffit OR DISPOSAL STSTE[ $1.00 STATE"CROACHMENT
PERMIT NO.
INDUSTRIAL
■ APPROVAL
CHARGES
OWNEE'S �T o0 CONNECTION CHARGE FEE
AUTHOEMUTION TOT gi FEE RE LY B U RSE■ENT FET, -
I HATE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT THE ABOVE DESCRIBED EUMNG DWELLING APP$OVALS •DATE INSPECTOR'S SIGNATURE
TO THE PUBLIC SEWER. �[/
SIGNED THI 0 1 k1��L NEW HOUSE S£'[ER
OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR TORIC
ADD - SEPTIC TANK,BEEP PIT(S) --_ -
AN OR DRAIXFIELEI
1 HEREBT ACKNOWLEDGIC THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE la CORRECT AND AGREE TO COMPLT CESSPOOL DQTWELL El
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR SEVER OR
PLUMBING AND SEWERS. ALTER, DISPOSAL SEWER
STSOR --
1 HEREBY CERTIFY THAT I All PROPERLY-REGISTERED ANEM
D/OR SMAGDISCONNECT P4UG/SND
LICENSED AS REQUIRED BT LOS ANGELES COU AND STATIC OF ABANDON HOUSE SEWER
CALIFORNIA 0k TKAT 1 THE LE F THE ABOVE
DESCRIBED RESIDENT PHQTY. BACKFILL SEPTIC TANKS
SIGNATURE BEEP.PIT a CESSPOOLS
OF
E"ITTEN
ATION ROBERT A WOOD
0.
l..o. us■ BUPBHYISINO YBCO-IANICI.L ENOINEIR
JCO209 JAN 231 0 A 5.00 A