HomeMy Public PortalAbout5951 CAMELLIA AVE_Sewer__ 7•ll•41D
moa 0.59 . APPLICATION FOR PERMIT
COIIWrf OF Los ANG>r SEWER—SEWAGE DISPOSAL
DUAanxr CW COUMTT >IINM
eUMMG AND SAFETY >oaYrs>ON BUILDIXp
))OO�� Cogv,o ADD
RSaa
CABU T DT� m.D. G>$IFFJ?i. /vp'!a!3u9dhm LOCALITY
NEAREST
FOR APP11CANT TO FILL CROSS ST
LEGAL
DEBMrnom LOT NO. OWNER r
BLOCK TRACT TAIL
ADDRESS
NO.OF BLDGS.
SIS of LOT NOW ON LOT CITY Tli�L lip,
USE OF
BUILDING D STRI GRDUP IAP HT
DK PQ
comnACTOR
ADDS CONIIEGTIO 4 DATA
GITT TYl-no "4 j! STATION DEPTH
STATERANHOLS REIrEM UPPER
REGI TION N0. COUNTY SHR
No. R PTI R ✓
o�ItcaE7ER CONXECTIXG TO
SHYER F CbmmECTioh LENGTHFROI
8 IC TII��NK,SEEPAGE AI OR T. CURB P.L. Ha-TO P.
PITS ANtI/OR DRAINFIELD a Moo
OVERFLOW SEEPAGE FAIT DRAINF ELD
RuxlTHO 3 SEWER CONNECTING TO P.C.
se IPO
I SAL OO CO.IMP.N0. JOB
COXXEC ADDS ORAL BLDG.OR TRUNK PERMIT NO. PEWIT X0.
A RX HOU SEYHR a SIM
X HOUSL I� �� STATE ENCROACHMENT
PERMIT NO.
INDUSTRIAL
WASTE APPROV
CHARGES
OWLS .MIT 2 00 CONNECTION CHARGE FEE '
AUMO=ATION TOTAL FEE REIYHURSEYENT EU ��
I HAVE AT THIS DATIr A CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT THE ASOYE DESCRIBED �ZISTING DWELLING OVAL DATE INSPECTOR'S SIGNATURE
TO THE PUBLIC SHWRI.
SIGNED THIS/ nAY OF _ 19_ NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT BUILDING OR WORK
ADDRF9m SEPTIC TANK,SEEP.PITS)
AN OR DRAINFIELD
1 HEREHT ACKNOWLEDGI THAT I HAVE READ THIS APPLICATION
AND STATY THATT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL DRTYELL
L-DE5MT;BE;D
ALL COU ItTi pRDIXAXCBS AND STATE LAYS REGULATING ALTER,REPAIR,SEVER OR M
PLUMBING AND fHWERE.
.EW
DISP08AL SYSTEM
BY CIDMIrT THAT 1 AN PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
AS REOUI BY LOS ANGELES COUNTY AND STATE OF ABANDON fl0U8H SEWER
A OR THA AN THE LEGAL OWNER OF THE ABOVE
RESID P ERTY. BACKFILLS C TANKS
SEEP.PIT 8 CESSPOOLS
VAj, L 0. SINGhtROBERT A. WOOD
at. L 0. �/J SUF'D73YI./IN0 HB:CHANIC.AL.VNOINB:R7t
L; 0 6 2 6 MY 1 1 1 0 A 3.0 0 .
APPLICATIONR-FOR PERMIT - 1
COVNff LOS ANG91= SEWER—SEWAGE DISPOSAL
MAsrdr OF GOUNTT
BUUXMG AM SAFM MVMOX EUILDIRG
CAM&rr X flap't of Buddha LOCALITY
g ,�.
MSCGAL
RIPTIOM LOT MO --'4740 Ae otRtiY
BLOCI 'TRACT Abn"rX
NO.Of 13LDQL
S UOPPLOT "[OT OR LOT f
U1$O
BU LDP1R DLST7:l�0. GROUP UK tAP re csaasD r
C0M'I'It/LCT'0[ � .
JLDD 0lVDATA
Tla-No. XTATIOh DI Fffi
44KMZ ONE
HEGIffI'RATIOR NO. �� COU Y k"H01K RfymuEMc=
Ro DSSCRjFTT5R-ZTW0RK FM
B C SIIEf��F�3CORHAA$QQ� m� IC 11
T-0 bo G
IC 1t'D IIFIELD .00 T. ��
0OF CURB k P L N&TO FitOt I
H � L
96na1 L HOTS oa
HOUSE &EVER CORRECTING TO P.C.'Ro.
"ATEDISPOlA.ITSTKI 1.00 oo.I[P.MolJOB NO
CO
RK TO 71DU ORAL BLD 4.OlF TYURT[Q. Rw!`min M0.
EO SEVER 1.00 I<PM
.STATE" OACHIE[T
A �Ig-0 HQU _
a Q ISPO 1.00 P�t[IT M
CHAYG[S
Ovnqmp 00 CORRECTIO[CHA2QK FIM
AVTSOHZZATION ro'rAL M, oo )MEBURSOM FEE
T$AYE AT THIS DATE A POK ACT WITH THI HEREIN K&W COR.
WQ TO RRECT THI ABOVE DESC,I 110 RQ MP RG A -)V DATii ) =]o '&S(OffArM
TPUBLIC SEWER-
SIGNED THIS 'Y nir z2vIt71 REM HODIrsroz R
ez
07 � E - BUILDSNG T 0Bn(TIOR/kL
Oyt{� cTAI1G�0&aEl•.PIT(&)
ADD ' OR D
I HEIIEBT ACLAOIALMM TAAT I HAV[ READ THIS A."U4ATIOR
AND 0TAYE THAT THE ASOYH IS C3DRRXCT AND GREE TO CQ[PLT CMMPDOL DMTWELL
rMALS. COUATT OGD)AAICES KM STATS LrtS [IGULATI[l Nr,RKPAIR."T oil
LU[a1NQ ARD � GE DISPOSAL STSTER
I HHP&BT CERT FT THAT I At MOPMLY RnHnaFM ARO✓OQ DI&COARECTPLUGAAM!�ID
� H
LICEMSM AS MUIT LAS ANGELES COURTT AND STATE OF =HOUSE SEVER
CALIFO 0RTHAT t A[ THE LEQAL OWIUM Qt THS LOM
I)ESCYIaL# D PYOFEItTT. BACIFILL c TA n❑
n G MTU➢I
PIT S CESSPOOLS
OF P /
Qf &MATION ROBERT A WOOD
[.qti YiM SUPXRYISLNQ hl1LCIi LMC.AL XKQLtJXM