HomeMy Public PortalAbout9640 CRAIGLEE ST_Sewer__ 76A6420 . A PUCATIO .- OR PERMIT E RMIT
5 a E-663 12.54 'r.',5�.74:�.r•
DIVISION. OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles. BUILDING .
WM. J. FOX, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST ,
CROSS ST. ••moi%/
LEGAL Z� / J' �llf ..,+t�ll `•
DESCRIPTION LOT NO. OWNER W
BLOCK TRACT ( MAIL J6 ✓
ADDRESS /?fFf �'+�/
+` NO. OF BLDGS. -
SIZE OF LOT.-$-"' ,( �S' / �,�' NOW ON LOT CITY �G TEL. NO.
USE OF
BUILDINGS „[�/t(._ - DISTRICT N0/ "GROUP MAP
CONTRACTOR _ �� I .� I �✓ i
7'
ADDRESS ,c-�,lrsa .-P.t,.�. CONNECTION DATA
CITY L. NO. STATION DEPTH
❑'STATE/ PIANHOLE REFERENCE
REGISTRATION NO. - .� [ICOUNTY I' �« bu' UPPER
TYfFOF CONNECT] J LENGTH FROM •'J/►f
NO. DESCRIPTION OF WORK FEE Y. CURB P.L. M.L.TO P.L.
HOUSE SEWER CONNECTING TO ^y, ,�{I
PUBLIC SEWER Q $ 3.50 50
_tel
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG:OR CO. IMP. NO. � �� JOB. NO.
_ WORK TO HOUSE SEWER 1.00 JJJ
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. ROAD PERMIT NO.
;DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT
_ AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO.
SEPTIC TANK,SEEPAGE PIT OR -
PITS AND/OR DRAINFIELD 2.00 INDUSTRIAL
CESSPOOL- DRYWELL WASTE APPROVAL
SPECIAL CONDITIONS ONLY 2.00 �. H GES
PERMIT 00 CONNECTION CHARGE E
7N
OVER'S t
AUTHORIZATION TOTAL,FEE J REIMBURSEMENT FEE
IHAVE TRACTORHIS DATE TO CONNECT THECTED ABOVEWITH THE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'SSIGNATURE
TO THE PUBLIC SEWER'
SIGNED THIS-DAY- DAY OF t9 NEW HOUSE SEWER , }
OWNER OR °=9P fi�� /'• CONNECT ADDITIONAL
OWNERS GJA/GENT '�f�-' $..-£</.�-'?i -4'`/� BUILDING OR WORK
- "'�-� l ,� •. SEPTIC TANK, SEEP, PIT(S)
ADDRESS S e'' - -
_AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR
PLUMBING AND-SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT '1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT. I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑
SEEP. PIT(S) ❑ CESSPOOLS
SIGNATURE
OF PERMITTEE Q"/� - - •
WILLIAM J. FOS /COUNTY ENGINEER VALIDATION
sYf�0 e a 5 SEP 12 4. 4.5 0
DEPUTY -DEPUTY
ST ST'
;® DEPUTY DEPUTY