HomeMy Public PortalAbout9617 CRAIGLEE ST_Sewer__ DEPARTMENT OF COUNTY ENGrN7EER SEWER-SEWAGE DBSPOSA6
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGd+.I.ES
WILLIAM J. FOX, COUNTY ENDINEER I BUILDING
ADDRESS
FOR APPLICANT TO FILL I LOCALITY
BUILDING I \ � /1(�,,�� V�
NEAREST
ADDRESS e _ CROSSST. tJ�,t1 /(I,J�L W
LOCALITY a DISTRICT N0. ISERIAL NO. f�/ PERRMIIT]NO.
NEAREST / ` 5- A r �V / a
CROSS ST. --
/� RECEIVED BY Ready for Inspection DATE ISSUED
OWNER / e _ .rd_ L_ II 91�l.. - �t' �� --6-
L
'U z
MAIL R USE ZONE OCCUPANCY MAP
ADDRESS SK PG
CITY
CONTRACTOR A CO.IMP.NO.
ADDRESS 0 Ll 4 4^AAJOB.NO.
CITY _L ; rz�EL.NO. ' TRUNK PERMIT NO.
�Sprl� �11,(] STATE
REGISTRATION 0. j( /) J �'❑ COUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT NO. PERMIT NO.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLOGS. CHARGES
NOW ON LOT
USE
BUILDINGS CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLICSEWER @ $ 3.50 RECEIPT NO. ( DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00 0,0
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO. DATE BY
_SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2:00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
i UPPER LOWER
TYPE OF CONNECTION LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERS PERMIT $ 100
AUTHORIZATION TOTAL FEE 4100
CONTRACTOHAVE IR TO CONNECT DATE THEED TOABOVE DESCRIBED IEXISTING ED APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER /
SIGNED THIS........__._.......DAY OF...._........._____.... NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT.................... BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS..............._....... AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. r CESSP00 DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,RE AIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE ESCRIBED RE TIAL PROPERTY. BACKFILL SEPTIC TANKS El
SIGNATURE SEEP.PIT(S)� CESSPOOLS I]
OF PERMITTEE.._ ...
76A642A 663 7/53
76A642D� (/–L111 II UCATMN FOR -PER111a1 T _ F)
S&E-663 11.55 dp{�
DIVISION OF BUILDING ARID SAFETY SEYWEfly-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles !1 BUILDING / /
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS (Q
® CASSATT D. GRIFFIN, SUPT of BUILDING LOCALITY
FOR APPLICANT TO FILL IN C"SS ST.
'LEGAL - OWNER
DESCRIPTION .LOT NO.-
MAIL
BLOCK TRACT , ADDRESS
NO.OF BLDGS. CITY TEL. NO. I
SIZE OF LOT NOW ON LOT
USE-OF DISTRICT NO GROUP MAP
° BUILDINGS•
_ 16BK PG
CONTRACTOR
•
ADDRESSIAleCONNECTION DATA -
,
8 STATION � Q�'� DEPTH ^�
5 CITY TEL. N0. — MANHOLE REFEREN_CE �® .- UPPER
STATE
o` REGISTRATION No. , ❑ COUNTY '
No. DESCRIPTION OF 15RK FEE
TYPE OF CON NECTION� LENGTH FROM
HOUSE SEWER CONNECTING TO - Y- CURB R PL•) M.L. TO P.L.
PUBLIC SEWER @ $3.50
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD @ $3.00
OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. N0.
EXTN.,CESSPOOL,DRYWELL,MANHOLE.@ $2.00 CO. IMP. NO. �,� Q.7 !OB NO.
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO.
CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT
WORK TO HOUSE SEWER @ $1.00 PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT $ 1 00
AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREI -' ' APPROVALS DATE INSPECTORS SIGNATURE
AAIAD .N��
TRACTOR TO CONNECT T ABOVE DESC LBED EXISTING DWELLING
TO THE PUBLIC SE .-�-7� NEW HOUSE SEWER l` Wq/ I
SIGNED THIS--�C -DAY OF 1 CONNECT ADDITIONAL
i OWNER OR BUILDING OR WORK -
OWNERS AG NT - SEPTIC TANK,SEEP, PITS)
ADDRESS 17 1p / AND/OR DRAINFIELD
IHERE Y'ACK 0 D ETHA' HAVE AFAb THIS APPLICATION „ CESSPOOL❑ DRYWELL❑
i AND STATE. THAT E ABOVE I ORRECT AND AGREE TO COMPLY
WITH ALL COUN Y ORDINANC S AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. , SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR `P
LICENSED AS REO IRED BY LOS ANGELES COUNTY 'ND ST TE OF DISCONNECT PLUG AND ,
C IFORNIA OR T AT I HE L AL OWNE TH V ABANDON HOUSE SEWER
DE C 1 ED SIDE L RTY BACKFILL SEPTIC TANKS❑
SR� r f ,SEEP. PITS) ❑ CESSPOOLS
P M TEE
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD. CHIEF PLBG. INSPECTOR
CK.