HomeMy Public PortalAbout5002 DALEVIEW AVE_Sewer__ DEPAUTMENT OF COIINTY ENGTNEES ,I
SEWER—SEWAGE DISPOSAL34251
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOXY COUNTY ENGINEERBUILDING
'I ADDRESS 'i 00 .'1 ��-L�(//E G✓
FNEARESTO
PPLICA I O F IN f LOCALITY �L /ydwreF
/� NEAREST t
// !S CROSSST. V1
r DISTRICT NO. SERIAL NO. PERMIT NO.
// // /�' �. /J _ A : -777p A
1�/jNL�(� (jyv-r I RECEIVED BYReady for Inspection DATEISSUED
MAIL - f�—
ADDRESS QL/�_4/ a USE ZONE OCCUPANCY BK MAP PG
CITY TEL.NO. �-
CONTRACTOR California Sewer Const_(!n_ CO.IMP. NO.
ADDRESS 1317 Colegrove Ave. JOBl O.
CITY Montebello TEL.NO.Unlon 1.-e048 TRUNK RMITNO.
REGISTRATION NO. 104448 STATE —'
LEGALQ t D S TE ROAD PER N0.
DESCRIPTION LOT NOS, 5 �f ,' • STATE ENCROA KM17ENT
PERMIT NO. -
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
T
SIZE OF LOT S SS- N0.OF BL I
NOW ON LOT CHARGES
USE OFs
BUILDINGS �/�/ CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
REIMBUflSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEW ER @ S 3.50 (/ RECEIPT NO. TE IBy
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CO N NECT ADDITIONAL BLDG.OR oOr EXCEPTION REC169DED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO' I DATE \1 13Y
_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 DRAIN FIELD 2.00 STATION 0 f76 0 DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 �pIN MANHOLE*
RREFERENCE LOWER
TYPE OF CONNECTIONLENGTH FROM
x— BURR P.L. M.L.TO P.L.
OWNERS NERMIT $ 1 00 OW
AUTHORIZATION TOTAL FEEAi
1 HAVE THIS DATE CONTRACTED WITH THE HERRN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO SHE PUBLIC SEWER
SIGNED THIS. .... .. ..DAY OF._.... -. __.____.__ I�_ NEW HOUSESEWER A'/1��
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT. . .. - BUI LDI NG OR WORK
ADD RESS L.57-6.1. . SEPTIC TANK,SEEP.PIT(S)
` +-/"'— ---- --Q' 'L- -- ----- ---- AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LI• CESSPOOL DRYWELL E]
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 I AM PROPERLY REGISTERED DISCONNECT PLUG AND
LAND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY STATE OF CALIFORNI OR THAT I AM THE LEGAL OWN. ABANDON HOUSE SEWER
OF THE ABOVE D C ED RETIAL PROPERTY. SEEP.PT(SEPTIC CESSPOSSNATURE SEEP.PIT(S)o CESSPOOLS PERMITTEE _.� _ .. _. ..._... _... -._../_
i
76A642A 663 7/53 ��