HomeMy Public PortalAbout9418 BARELA AVE_Sewer__ {
79^° APPLICATION FOR PERMIT 1
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DIVISION OF.]U=ING AND SAFETT SEWER--SEWAGE DISPOSAL
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FBIJOHN A. LAMBIB, COUNTY ENGINRete ESS 64,18- Rq,ela
CAS:SATT D.GRIFFIN, SUPT of BU]LOINtl LITiFOR APPLICANT TO PILL IN ST.
LEf�AL
DEECAIFnOR LOT X0. - OWNER _ Mrs Pa].rrler -
BLOCK TRACT MAIL ,,dd --11.,.,, -
ADDRESS .i.0 B8161tL ifT
SIZE OF LO NOW ON LOTNO.OF S CITY TSI.. R0. LU 7Q530
NSUuuSQ OF DISTRICT NO, agOUP YAP
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CQRTItACTORTcl G`
ADDRESS G Ave, ' CO X DATA '
Am STATION DEPTH
CITT T�1... ■0. til OLE EF CE _ UPPER
��.yy STATE LOWER
REGISTRATION NO. (j. �I CbUIFFY O
/S--
mo, DESCRIPTION OF WORK FEE
HOUSE SEWB3i COMXECTI G TO TYPE OF COXRSCTION LENGTH FROM
PUBLIC SEWER ! SO Y. QURB P.L. Y.L.TO P.L.
$EFTIZ TAX , T OR
SEEPAGE PI
PITS AND/OR IRAIXFIELD Q $ 00
OY LOW SEEPAGE PIT,DRA XFI LD P. C. No
EXTN., SPOOL DRYWE L MANHOLE @ 2.00 CO. IMP.X0. JOS R .
HOU9S COR CTI TO
.PRIMATE QISPOJALSYSTEY 1.00 TRUR PEt IT NO. ROAD PERMIT NO.
CONNECT AI)DITI02(AL BLDG.OR 00 STATE EXOROACHMERT.
MO K 0 HOUSES ER f 1.0 00 PERMIT N0.
ALTER, AIR OR ABANDON USEMDUSTRIAL _
SEWER.OR DISPOSAL SYSTEM 1.00 WASTE APPROVAL
CHARGES
CONNECTION CFMQE FEE
OVA'S PEB39T i 1 00
REIYBURSEMERT FEE
AUTHORIZATION Toru FEE � -
I HAVE AT THIS DATE /� CONTRACT WITH THE HEREIN NAMED CON-
APPROVALS DATE IXSPtCTOR'SDIGHAT4RE
TRACTOR TO CONNECT THE ABOVE DESCRIBED E](ISTIMG DWEI,WXG
TO THE PUBLIC SEWER. r- PrESf H0U363EWER -
SIGNED THUl SAY QF 19 CONNECT ADDITIONAL
OMNIIR OR _ BUILDRIG O WORk 'r
4WNERA AaQT SEPTIC TASK,SEEP,PIT(a)
ADDRESS ARD/OR DRAINFf D
I HERE&T ACKXOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND $TACE THAT TH6 ABOVE. IS COR[}ECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AMD STATE LAMS REGU.LATMG ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSASYSTEM
I HEREBY CERTIFY THAT 1 AY PROPERLY REGISTERED AND/OR DUSCORRECT PLOD AXD
LICENSED AS REOUI BY L03 ANGELES COUNTY AXD STATE OF A9AXDON HOUSE SETER
CALIF0RNLA OR T 1 AY THE LEGAL 0 OF T4JE ABOVE
DESCRIBED RtSID PROPERTY, BEEP.IErACKFLLPIT TIC❑ C AN
KS SSPD El
OF PERYI'ITgg
JOHN A. Gou ENGINEER 4owV ATION ROBERT A.WOOD.CHIMF PLJSG.INQPS:CTOft
�S4a2Et' JL31 1p A 2.00 -
T
76A"1D APPLICATION 'POR PERMIT 1
r 866DIVISION OF BUIMING AND SAFETY SEWER—SEWAGE D I S POSA L
D.palltnaw of c�.>stp E2>Q12>..�
Com of La A21Q�l�s GUILDING
WM.J. FOX, COUNTY ENGIPJMM ADDRESS
CASSIATT D. GRIFFIN. •LIP'T OF BUILDINGK
LOCAL TTY
FOR CANT TO FILL IN NEARCIZO39 3T.
LEGAL
DSJCRIPTION LOT NO. OtXBII
BLOCK TRACTPAIL
ADDRM
NO. OF BLAS. :I
SIZE OF LOT 51AX NOW ON LOT CRY 'TEL. NO.
US¢OF
BUILDINGS DISTRICT. GROUP I YAP
DK PG
CONTRACTOR P
i
ADDRESS Ij 0j:6CONNECTION DATA
CITY TEL. 110. STATION YL '1 DEPTH
ATE MANHOLE RIFEREXC /
REGISTRATION NO. S ❑ COUNTY - �T WER
TYPE OF CONNBCTI LENGTH FROM /
No. . DESCRIPTION OF WORK FEE Y. CURB P.L M.L.TO P.L.
USE SEWER CONNECTING TO
'P BLIC SEWER ;< 3.50 G
HODS SEWER CONNECTING TO
PRIVDISPOSAL BYST¢M 1.00
.CONNE /ADDITIONAL BLDG. OR 00. IMP. No. JOB. NO.
WORK 7 OUSE SEWER 1.00
ALTER O itEPAIR EXISTING
SEWEI R DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. ROAD PERMIT NO.
DISCO T AND ABANDON SRWILR STATE ENCCOACHY7JIT
AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO.
SEPTIC TANK,SEEPAGE PIT OR
PITS AMD/OR DRAINFIELD 2.00 INDUSTRIAL
CESSPOOL-DRYWELL WASTE APPROVAL
S PE C IAL CONDITIONS ONLY 2.00 CHARGES
CONNECTION CHARGE FEE
O�VNEB'8 P�Mn ; t o0
Aum6=ATION TOTAL M Q REIMBURSEMENT FEZ I HAVE A, Q
TRACTORTHIS.DATE TO CONNECT THEACTED WITH THE ABOVE DESCRIBEDHEXI ERHIN NAMED LCO G APPROVALS D T F1 INS OR'S SIGN RE
TO THE PUQLIC
SIGNED THI�DAY OF 18 `S NEWHOU3¢sH}HR j `z'+'c4
OWNER OR CONNECT ADDITIONAL
OWNERS AGER BUILDFRG OR WORK
SEPTIC TANK, BEEP,PIT(S)
ADDRESSAND/OR DRAINFIELD
1 HEREBY ACKNOWI 411,'lHAT 1 HAVE READ THIS APPLICATION CESSPOOL ElL[IDRYN¢L
AND STATE THAT•TH¢ ABOVE 13 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY 0RDINANCn AND STATE LAYS REGULATING
PLUMBING AND SEWER$. ALTER, REPAIR,EW£A OR
611SEWAGE DISPOSAL ER OR
I HEJREBT CERTIFY THAT I AN PROPERLY REGISTERED AND/OR DISCONNECT FLAG AND
EM
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AY THE LEGAL OWNER OF THF ABOVE ADANDON HOUSE SEWER
DESCRIBED RESIDEYTIAL PROPERTY. BACKFILL WEPTIC TANK$
0001, fYIP. PIT(S)
SIGNATURE L
OF PE3RM1
WILLIAM J. FOX, uNrY I3NGINBDLi VAI.MATDON
ACO 75 2 E. SEP 6 4 4.5 0
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DEPUTYDEPUTY
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DEPUTT DEPUTY