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Home My Public Portal About4909 FRATUS DR_Sewer__ F-663 S&E•863 11.55 - .. APPLICATION FOR PERMIT S& DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRES6 S G ® CASS ATT D. GRIFFIN, SUPT OF BUILDING LOCALITY C FOR APPLICANT TO FILL IN CROSS S. LEGAL OWNER DESCRIPTION LOT NO. MAIL BLOCK TRACT ADDRESS / / f N0. OF BLDGS. �J CITY TEL. NO."-77- 0. C�kla d_ • SIZE OF LOT f NOW ON LOT J'C_ BUILDINGS [ —'r"?•�-•- DISTRICT NO. GROUP MAP / I BK �P3 CONTRACTOR _✓• Gr-�,�_, r �I2¢- �� ,, ADDRESS 21— (� CONNECTION DATA CITY TEL. NO, � a�p`Z,� ei� STATION V7 0 DEPTH MANHOLE REFERENCE © -7 ;/ PPER• _ ❑ STATE REGISTRATION N0, l� _ � --E9--GBt}NTh No. DESCRIPTION OF WORK FEE TH FROM HOUSE SEWER CONNECTING TO Y TYPE OF CURBCONNECTIO/(P.L. / MEL TO P.L. PUBLIC SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD Q $3.00 OVERFLOW SEEPAGE PIT, DRAINFIELD - CO. IMP. NO. P- EXTN.,CESSPOOL,DRYWELL,MANHOLE Q $ 2.00 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM Q $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER Q $1.00 PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM Q $1.00 WASTE APPROVAL CHARGES x CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED coN� APPROVALS DATE INS' ECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING n4 TO THE PUBLIC SEWER. NEW HOUSE SEWER a ' 0 % v-, SIGNED THIS-D Y OF 19 * CONNECT ADDITIONAL kk OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I 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 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 1 AM TH EGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP BACKFILL SEPTIC TANKS❑ SIGNATURE y SEEP. PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE �' JOHN A. LAMBIE, COUNT NGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. M.0. CASH