HomeMy Public PortalAbout4908 FRATUS DR_Sewer__ °
5aE663 i1-55 APPLICATION FOR PERMIT 1
S&E 8
DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Deportment of County Engineer
County of Los Angeles BUILDING �� �
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS i (J �, �
® CASSATT D GRIFFIN, SUP T-OF BUILDING LOCALITY ll__�C
FOR APPLICANT TO FILL IN CROSS ST
LEGAL
DESCRIPTION LOT NO OWNERMA L
BLOCK TRACT / ADDRESS22
NO OF BLCITY TEL NO C 6 ��1 b�
SIZE OF LOT NOW ON LOTT
USE
BUILDINGS DISTRICT NO GROUP MAP
� �s.✓.L.
CONTRACTOR , 6 PG '
ADDRESS •-�(}� + ,� — CONNECTION DATA
�ti'- STATION - t.LJ �� DEPTH r"
` CITY CZaIiG�, TE�L/ NO MANHOLE REFERENCE PER
REGISTRATION NO �f ,`J 0 STATE
NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION---q% LENGTH FROM
HOUSE SEWER CONNECTING TO Y CURB P L j 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 NO
EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $ 2 00 CO IMP NO w{A8•#6-. � ��
HOUSE SEWER CONNECTING TO -!
PRIVATE DISPOSAL SYSTEM t@i $1 00 TRUNK PERMIT NO ROAD PERMIT NO
CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT
WORK TO HOUSE SEWER u $1 00 PERMIT NO
ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM Qt $1 00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT S 1 00
AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING `
TO THE PUBLIC SEWER NEW HOUSE SEWER Qen -
SIGNED THIS DA 19 CONNECT ADDITIONAL ~
OWNER OR BUILDING OR WORK -
OWNERS AGENT ~ SEPTIC TANK,SEEP,PITS)
ADDRESS AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE 15
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 I 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 PRO BACKFILL SEPTIC TANKS❑
SIGNATURE ✓ SEEP PIT(S) ❑ CESSPOOLS❑
OF PERMITTEE
JOHN A LAMBIE COUN Y ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CK N O CASH
X1 9 1 3 i - JUN 11 . 4 4.5 0 In