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HomeMy Public PortalAbout5016 DALEVIEW AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER � SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETYPERMIT APPLICATION COUNTY OF LOS ANGELES - WILLIAM J. FOX, COUNTY ENGINEER I BUILDING CQ/is Ta/� /,�u� _ ADDRESS J (p LJ FOR AP PLI T T FILL IN LOCALIr —' , BUILDING (� NEAREST ADDRESS CROSSST. r'�h LOCALITY - A' • DISTRICT NO. SERIAL N0. PERMITNO. NEAREST JvA gc,6,s S CROSS ST. R EIVED BY Reedy for Inspection DATE ISSUED OWNER MAIL USE ZONE OCCUPANCY I BK MAP PG ADDRESS CITY TELNO. A -1 CONTRACTOR D CO.IMP.NO. ADDRESS / JOB.NO. CITY TEL.NOaxAl . O TRUNK PERMIT NO. STATE REGISTRATION REGISTRATION NO. /O. B COUNTYB COUNTY ROAD PERMIT N0. LEGAL STATE ENCROACHMENT DESCRIPTION LOT N0. PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO.OF BLDGS. NOW ON LOT CHARGES USE BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER QS 3.50 RECEIPT NO. I DATE IBy HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 Q - CONNECT ADDITIONAL BLDG.OR _ EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 _ ALTER OR REPAIR EXISTING NO. I DATE IBY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ANO/OR DISPOSAL SYSTEMN SEWER 1,00 O CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR GRAINFIELD 2.00 STATION -- DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 Z CD o MANHOLE REFERENCEUPPERLOWER TYPE OF CONNECTION LENGTH FROM Y. CURB P.L. M:L.TO P.L. OWNERS PERMIT S 1 00 AUTHORIZATION TOTAL FEE 010 n 1 HAVE THIS DATE CONTRACTEDWITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S/SIGNATURE DAT DWELLING TO THE PUBLIC SEWER ' SIGNED THIS................DAY OF._.._...__-_.__...____19_-__ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT.......................................... BUILDING OR WORK ..-.._........_._.._.._...-.._.._-._-._.-_.._. - SEPTIC TANK.SEEP.PIT(S) ADDRESS.............._................................................................... AND/ORGRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL RYWELL 'CESSPOOL ,. RYWELL ' ,�c�� �/� �/ / 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 AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA R T AT 1 AM THE LEGAL OWN- ABANDON HOUSE SEWER ER OF THE ABOVE D SCR D SID IAL PE BACKFILL SEPTIC TANKS 0 SIGNATURE SEEP.PIT(S)E] CESSPOOLS[] OF PERMITTEE. _.. ... .. 76A042A 663 7/53 ]DEPARTMENT OF COUNTY ENGRU= SEWER—SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES ) WILLIAM J. FOX, COUNTY ENGINEER I ADDRESS 1 FOR APPLICANTEFILL LOCALITYNEAREST .ADDREss hoTB T)P cftOSSST. (if/ — �es eDISTRICT N0. Ready for Inspection PERMIT NO. LOCALITY Temple Ci y \NEAREST Grand 3, 5 CROSS Sr. �F/��r R CEI D BV DATE ISSU DBVGATE OWNER 1).�_ "� MAIL USEZOdE OCCUPANCY RK MAP PG ADDRESS $$IRs CITY same TELAO. CONTRACTOR JOIM A. biskovie� . c MP.NO. ADDRESS 274.3 E P, ave _ JOB NO. CITYE1 IYionte TEL.NO.FO. 8-8469 TRUNK PERMI 0. / REGISTRATION N0. 1. TE COUNTY ROAD PERMIT N0. LEGAL STATE ENCROACHMENT DESCRIPTION LOT N0. PERMIT NO. BLOCK TRACTt(�'�' 0 INDUSTRIAL NO.OF BLOC . WASTE APPROVAL G/Tf! SIZE OF LOT y -112, NOW ON LOTCHARGES /0 S ' 6� USE OF BUILDINGS �� S CONN ECTIO5,C ARGE FEE NO. DESCRIPTION OF WORK FEE / HOUSE SEW Efl CONNECTING TO REIMBURSEMENT FEE _ PUBLIC SEWER F 3.50 '/RECEIPT NO. DATE BY OUSE SEWER CONNECTING TO -PRIVATE DISPOSAL SYSTEM 1.00 _ CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED .WORK TO HOUSE SEWER- 1.00 _ ALTER OR REPAIR EXISTING NO' I DATE IBY SEWER OR DISPOSAL SYSTEM 1.00 _ DISCONNECT AND ABANDON SEWER _ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTICTANK,SEEPAGE PIT OR PITS AND/OR GRAINFIELD 2.00 STATION 2-* Z 7 DEPTH CESSPOOL-DRYWELL SPECIAL CONDITIONS ONLY 2.00 /4// ...5 R MAN 21 ERENCE TYPE Of CONNECTION iCENGTH FROM ` f OWNERS PERMIT { 1 RO Y. CURB P.L. ✓ M.L.TO P.L. ly AUTHORIZATION I OTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING - APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER ,.g� SIGNED THIS— Y OF _I9� NEW HOUSE SEWER ^, + _ /.2 OWNER OR - �/ CON NECTADDITIONAL OWNERS AGENT.. ._ =.. ___.- BUILDING OR WORK p� / /� /. )_ -- SEPTIC TANK,SEEP.PIT(S) ADDRESS.. -[i-iV}-------}-4je:IV _ -E�c" ...-.--- AND/OR GRAINFIELD _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL Q 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND A D STATE OF CALIFORNIA OR THAT 1 A TXE L GAL OWN- ABANDON HOUSE SEWER ER OF THE ABOVE DORM OR RESIDENT L PR ERTY. BACKFILL SEPTIC TANKS n - SEEP.PIT(S)Q CESSPOOLS©- AA��}(r�a /a.-.J� S9 SIGNATURE OF PERMITTEE... r!ft 76A642It S&E 063 4/54 Q//