HomeMy Public PortalAbout6114 BURTON AVE_Sewer__ T DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION _
COUNTY OF LOS ANGELES gUG
iLDIN
WILLIAM J. FOX, COUNTY ENGINEER I qpO RESS�j/�
FOR APPLICANT TO FILL INLOCALITY �
BUILDING ? NEAREST
ADDRESS & T T7L
CROSS ST. Gam/
LOCALITY � � ,9 (�
DISTRICT N0. SERIA N0. PERMIT N0.
A 7t//1 S
CROSS ST. C,Q-/�./f;��"'OJ� RECEI ED Ready far Inaoectlon DAX ISSUED
OWNER �1y7"hI�/)J .ri ICGG N"�. ��� �j�J
MAIL �LSEZ OCCUPANCY �HA'P-
ADDRESS ^ // / /BK PG
CITY �� TELAO. ,+_rG_7bp3 / /N / /��5 / 12 -7
CONTRACTOAT-
0 F4A) !
/BICC cI ix I+ CO.IMP.No.
ADDRESS �''7 L �� J JOB NO.
CITY TEL. TRUNK PERMIT NO.
7 STATE
REGISTRATION N0. ��.3�X� - "W" ROAD PERMIT N0.
LEGAL
'DESCRIPTION LOT N0. /T STATE ENCROACHMENT
p PERMIT NO.
BLOCK TRACT �/ J - 0 5� INDUSTRIAL
+J WASTE APPROVAL
SIZE OF LOT�� X /QO NOW ON LOTS (� CHARGE
BUELDI NGS /��5 9f- �'KIC. CONNECTION CHARGE FE_E
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECT NO
TO REIMBURSEMENT FEE
PUBLIC SEWER @ S 3.50 RECEIPT NO. DATE\ I BY
HOUSE SEWER CONNECTING TO
P RIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
" WORK TO HOUSE SEWER 1.00 NO. DATE IBV\
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE
PSAND/ORDRAFIELDIT OR
TN200 22
CESSPOOL—DRYWELL STATION DEPTH
SPECIAL CONDITIONS ONLY 2.00 �/ r/C MANXPPER� //nIc REFERENCE4J ,LI
,G��✓ V CUT'D.YLER'
_ TYPE DFCONNECTIOY� LENGTH FROM 2 O I
OWNERS PERMIT s I DD B P.L,J M.L.TO P.L.
AUTHORIZATION TOTAL FEE bTJ
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING, APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THEPUBLIC SEWER—(�
SIGNED THIS.-7.-L-..... AY OF._.. .((_..`/ryJ',..._-.._1/9.���1 NEW HOUSE SEWER ,1,q
OWNER OR Y ` .� p�"�S� CONNECT ADDITIONAL /7 t
' OWNERS AGENT........._........... ..... -._.._.... _.1IL✓. ..._.. ..._ BUILDING OR WO RK I/
ADDRESS.:�y ��L SEPTIC TANK,SEEP.PIT(S)
-- - (}{Z-j-G --- -- --- --- ------ AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL E] DRYWELLC]
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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTEREA
AND/OR LICENSED AS REDIi RED BY LOS ANG ES COU EV DISCONNECT PLUG AND
AND STATE OF'CALIFORN R THAT 1 AM T LEGAL N.
ABANDON HOUSE SEW ER
ER OF THE ABOVE DESPAI D RESP ENTIA P OPERT BACKFILL SEPTIC TANKS
SIGNATURE I
SEEP.P[T(S)E] CESSPOOLS T17�lu6A
_
OF PERMIT,TEE... .. .._.._ _! ... -.._...--------.._...- _
56A642A G83 7
IDFPART:KENT OF COUNTY F—NGLN'EER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENGINEER I BUILDING
ADORES$
FOR APPLICANT TO FILL IN LOCALITY .S G-
BUILDING // �/ NEAREST
ADDRESS (O // _/ /?J'J LI T"D IJ _ CROSS ST.
LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO.
NREST /� � Ch 4"'e L—� A 30 75el�
EA3v 7
CROSS ST. `'�-/� RECEIVED-By Ready for Inspection DA I�E�
OWNER
MAIL �+ ^ USE ZONE OCCUPANCY .BK M'(P PG
ADDRESS
� v C
--CITY 1 ^ TJ'E�L.NO.//
CONTRACTOR (/(� Al /SJf T J Irl f p CO.IMP.NO.
ADDRESS '� Cl/ "j Q A U—'_ JOB.NO.
CITY 44 �`l.lfu.. �- p TELAO. TRUNK PERMIT NO.
STATE
REGISTRATION NO. ❑ COUNTY ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT N0. //(/ STATE ENCROACHMENT
/` PERMIT NO.
BLOCK TRACT`SCJ(j Pei � //) )` INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT Sax
. / e 0 NOW ON LOTS � I CHARGES
USE
BUILDINGS D�S /- p Q/I e— CONNECTIONCHARGE FE
/I l:A
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUSLICSEWER 111 S 8.50 RECEIPT NO. DA IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDEk
WORK TO HOUSE SEWER 1.00
ALTER ORAMSP*M?EXISTING Jy No ( DATE BY
SEWER ORAMB0091000611FIFFSA1 1.00 !/
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/OR DRAINFIELD RAO STATION r`s DEPTH--
SCESSPOOL—DRYWELL �gE��
PECIAL CONDITIONS ONLY 2.00 �ANUPFMU.9F t
TYPE OF CONNECT�Q��R_ �LENGXH•FROM
M.L.TO P.L.
OWNERS PERMIT ; 1 00
AUTHORIZATION TOTAL FEE -
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING- APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS.._;:l 9._._DAY OF..._ 'fg19.' NEW HOUSE SEWER
CONNECT ADDITIONAL U
OWNER OR �jlp - BUILDING OR TION
OWNERS AGENT. h....._..^�.^_.._.._.. .___.._ _..!...__.._.._
ADDRESS......t.^.-I` _...... SEPTIC TANK,SEEP.PIT(S)
_ ..:f..Y-Y.. h e�J.._._.........._._.
' AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI-, CESSPOOL E] DRYWELL El
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 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN. ABANDON HOUSE SEWER
ER OF THE ABOVED/ €SCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS 0
SIGNATURE I\�-�/f'Y/5 /{/ i/ SEEP.PIT(S)Q CESSPOOLS
OF PERMITTEE..._... .. .._.—.. ....�1.. ...
70A042J 663 7/53 '