HomeMy Public PortalAbout6232 ENCINITA AVE_Sewer__ DEPARTIIffiNT OF COUiri/ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY ��$ PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER Q' 4�IpDDRESS _72-
XIBUILDING
FOR APPLICANT TO�FILL IN \\ I9 LO A tTY ��y �J� �j�
BUILDING �Z3Z // /-/F4�/�Y/�LL \� ;CROSS ST: CC .'BUILDING
LOCALITY 1� /0r / �g DISTRICT N0. LI SERIAL N0. PERMIT N0.
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NEAREST P /� A ® J
CROSS ST.
/� .mfr RECEIVED BY Ready far Ins0eatlon D1TE ISSUED
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CONTRACTOR ,�Q� CO.IMP.NO. / '1-!2
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ADDRESS �-sr V
JOB.N0.
CITY TELAO. TRUNK PERMIT NO.
STATE
REGISTRATION NO. e COUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT ----
DESCRIPTION LOT NO. PERMIT NO.
BLOCK TRACT USTRIAL
WASTEAPPROVAL
SIZE OF LOT N0.OF BLDGS.
NOW ON LOT CHARGES/USE OF
V'
BUILDINGS � �°I'� CONNECTION CHARGE FEE Yi�
No. DESC PTION l WORK 'FEE
REIMBURSEMENT FEE
IHOUSE SEWER CONNECTING TO
PUBLIC SEWER 0 $ 3.50 � 5� RE PT NO. DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00 _
CONNECT ADDITIONAL BLDG.OR EXCEPAQ..4 RECORDED
WORK TO HOUSE SEWER 1.00 D O
ALTER OR REPAIR EXISTING No' DATE _-' ,l BY
SEWER OR DISPOSALSYSTEM 1.00
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR /
_ PITS AND/OR GRAINFIELD 2.00 STATION ���b. DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 / ,,LMANHOLE REFERENCE
UPPER SB#BB
_ TYPE OF CO INECTION LENGTH FROM
M.L.TO P.L.
OWNERS PERMIT S 1 00 rule Ssl. u
AUTHORIZATION I TOTAL FEE iv 6-0
1 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
SIGNED THIS------------------_DAY OF.�.�..�.._L-----------------19.52 NEW HOUSESEWER �yy
OWNER OR CONNECT ADDITIONAL
OWNERS A ENT..-._ _._. — BUILDINGORWORK
ADDRESS SEPTIC TANK.DRAINFEP:PIT(S) '
_ __�•2.....�.CS._._.... ...^._•.�:�:�'-_:1:-T..��•'!. AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL 0 DRYWELL 0
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 DISCONNECT PLUG
AND/OR AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUGESAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTJAL PROPERTY. BACKFILL SEPTIC TANKS / A
SEEP.PIT(S)EI CESSPOOLS
SIGNATURE YL�ftZLaif D'y7 3
OF PERMITTEE..._....__..__ ....._..._......_..__ ...
76A642D C63 1/53 �K
DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER - I ADDRESS
FOR APPLICANT TO FILL IN , L0CALITYBUILDING
�•//�yi� f��/P
_ADDRESS �_�� � �irl.f_ i�is S�� S NEAREST
CROSS ST. in/yq�,�� �y/I/
LOCALITY T.�.. OO �" DISTRICT NO. 'SERIAL NO. PERMIT NO. �•
NEAREST nl �J A -- J A //�jc�'d J
CROSS ST. �J .��,Q/Y�• \ RECEIVED BY Ramd,for Inspection �D/ATE IS
SUED
OWNER � � ]�.( A rN.N—�✓ ��t�'C/i'� 1 /�il/IS-3
Una _4 A M P
ADDRESS. USE ZONE I OCCUPANCY MAP
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CITU .cf TEL.NO.Ar fp3jS y
CONTRACTOR tii e ref,
CO.IMP-t1Q,`�/ �2 / /
ADDRESS .S� M •�
JOB.N0. �--
CITY f TELAO. /•
TRUNK PERMIT'NO---------
[[]] STATE
REGISTRATION NO. ❑ COUNTY ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT NO. .QA,2_ Q� t A /1 STATE ENCROAC_HMENT�
=.--u /' PERMIT NO--
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL^�
SIZE OF LOT N0.OF BLDGS.
NOW ON LOT � \ CHARGES
USEOF
BUILDINGS __ Q � CONNECTION CHARGE FEE
NO. DESCRIPTIO OF WORK FEE �• /
REIMBURSEMENT'FE_E
NOOSE SEWER CONN ECTINO TO f ;� �� RECEIPT NO. 1� ATE BY
HOUSEPUBLIEWER @ S 3.50 �\
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00COWN /'�
WORK TO HOUSE SEWER LDC.OR 100 0 EXCEPTION RECOR DED
ALTER OR REPAIR EXISTING J NO. I DATE �I,BY
SEWER OR DISPOSAL SYSTEM 1.00 �/
DISCONNECT AND ABANDON SEWER \
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR /L—DRYWELL '
PITS AND/ORGRAINFIELD 2.00 STATIONCESST DEPTH
SPECIAL CONDITIONS ONLY 4.00 / MANHOLE REFERENCE
UPPER —C�4ER•
TYPE OF CONNECTION LENGTH FROM
CURB _44b r M.L.TO P.L. C.O
OWNERS PERMIT $ � I 00
AUTHORIZATION TOTAL FEE S
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
SIGNED THIS...................DAY OF----- �.P...19. 3 NEW HOUSE SEWER
OWNER OR n CONNECT ADDITIONAL
OW
OWNERS AGENT........fJ-1.�.... o. BUILDING OR WORK
// SEPTIC TANK,SEEP.PIT(S)
ADDRESS...lF..�w..3...7. .'... ._.Sr.....Ks.pcsnt,{y..._ ..�.,.._�.. AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI. CESSPOOL DRYWELLE]
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 OR THAT I AM THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTICTANKSEl
�j SEEP.PIT(S)0 CESSPOOLS
SIGNATURE r_ // . r ;: r
OF PERMITTEE.. ._. '- 1/S�(
7GA642D 663 1/53 I