The URL can be used to link to this page

Home My Public Portal About6234 BURTON AVE_Sewer__ CEBOB3.B2 76A642D APPLICATION FOO' PERMIT IIJJ COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION ADORE NO 623 Burton St. JOHN A. LAMBIE. County Engineer ADDRESS WILLIAM A. JENSEN, Supt of Building LOCALITY Sari GabTi1 NEAREST FOR APPLICANT TO FILL IN CflO55 ST. 9 LEGAL DESCRIPTION LOT NO. 5 OWNER 5903 MAIL BLOCK TRACT ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT 14 CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGSj/ BK PG CONTRACTOR H Williams ill aLLls ADDRESS 2315 Ey 118 §t. . CONNECTION DATA CITyp Ay 59 Califs , No 566460 5 ATION DEPTH REGISTRATION NO. 139099 ® STATE COUNTY MANHOLE REFER NO, DESCRIPTION OF WORK FEE TYYPE�OF—C:C NE O LENGTH FROM L_.(' A 6 HOUSE SEWER CONNECTING TO Y. E / P.L. M.L.TO P.L. O PUBLIC SEWER @ 55.00 V�Fp SEPTIC TANK.SEEPAGE PIT OR P.C.NO. v PITS AND/Oft DRAINFIELD 510.00 CO.IMP. NO. 'vq JOB NO. PRIVATE DISPOSAL Sfx HOUSE SEWER Y3TEMG TO $3.00 TRUNK PERMIT NO. ROAD PERMIT NO. O CONNECT ADUITIONAL LDG.OR AFFIDAVIT I WAI"IASIKIxl I RECORD,IN5TR,NO. DATE WORK TO HOUSE SEWER ® $3.00 YYY...III OVERFLOW SPA..FIT.DRAIN5IELD N EXTN..CES SPOOEEL.DRYWELL. A O .0 LE@ 550 z ALTER.REPAIR OR AB ND J USE HWY.OR ST.WIDENING SEWER OR DISP03A Y C ® 53.00 STATE ENCROACHMENT PERMIT NO, C INDUSTRIAL WASTE wPPROV qL OWNERCHARGES S PERMIT 5 AUTHORIZATION I TOTAL FEE S� CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'5 SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR � /� NEW HOUSE SEWER WN-3 OWNERS AGENT_ CONNECT A BUILDING ORR WORK WORK DOgE55 SEPTIC Tq NK,SEEP,PIT 131 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ANO/OR DRA INFIELD AND STATE THAT THE ABOVE IS CORRECT S AND AGREE E COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRV WELL ❑ I HEREBY CERTIFY THAT ' AM PROPERLY REGISTERED ANO/OR ALTER,REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE D SI:RIBED RESIDENTIq PROPERTY. ABANDON HOUSE SEWED SIGNATURE PERMITTEE .qG -BACKFILL SEPTIC TANKS ❑ OF PERF' SEEP.PIT(S) [ICESSPOOLS ❑ VALIDATION ROBERT A. WOOD <K. M.O. SUPERVISING MECHANICAL ENGINEER AEH LT i 5 3 2 r1 CEBOB3-B2 TBAeazD APPLICATION"FQR PERMIT u COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION Bu ILDI G '-• JOHN A. LAMBIE. County Engineer ADDR - Rl1Tton=_ WILLIAM A. JENSEN, Supt o1 Building ' LOCALITY San Gab- e1 NEAREST FOR APPLICANT TO FILL IN `ROBS ST. L9n a _ LEGAL DESCRIPTION LOT NO. 5 OWNER MAIL BLOCK TRACT �j Cln ADDRESS ✓. NO. OF BLOG9. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF y BUILDINGS Ire DISTRICTNO. GROTP MAP PROCE55ED BY BK PG CONTRACTORWilliamsH. 7 rtl ADDRESS 2315 E. 118 St. cY CONNECTION DATA c/ _ � CITY A �9y if L. NO. 56,6��g5 TION I STATE DEPTH Aj UPPEF REGISTRATION NO. 139099 COUNTY MANHOLE REFEF}T{ R i r No. DESCRIPTION OF WORK FEE TYPE OFC NLENGTH FROM HOUSE SEWER CONNECTING TO Y. C P.L. M.L.TO P.L. PUBLIC SEWER @ 45.00 19 O SEPTIC TANK.SEEPAGE PIT OR J��AI P.C.NO, CO.IMP.NO. ``�J JOB NO. {.J PITS FNDIOR GRAINFIELD @ SIO.00 �Y HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. O a gm PRIVATE DISPOSAL SYSTEM @ 43.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT wAIVIII A5Z RECORD,INSTR.NO, DATE WORK TO HOUSE SEWER Cn S3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN..CESSPOOL.DRYWELL,MA N HOLE 55.00 -V) ALTER.REPAIR OR ABANDON HOUSE HW.. OR ST.WIDENING ��JJ SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS pEAMTT s z 00 CHARGES AUTHORIZATION TOTAL FEE i 7 CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19OWNER OR _ _ ` �v� NEW ECTSESEWER OWNERS AGENT /',/.// CONNECT ADDITIONAL ADDRESS BUILDING ORRWORK WORK SEPTIC TANK.SEEP,FIT(S) 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ ORYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER.REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE ABOVE EB RIBED RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE OF PERMTTTEE 'BACKFILLSEPTIC TANKS ❑ SEEP.PIT I51 ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD CK. M.o. CASH SUPERVISING MECHANICAL ENGINEER u:a 5 3 2 OC^ �1M' i C A TOO— y