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Home My Public Portal About9564-66 GARIBALDI AVE_Sewer__ DEPAI rMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS FW APPLICANT TO FILL IN LOCALITY BUILDING /� � /e�6sl�/ NEAREST ADDRESS •�—�'� �+ >,Di CROSS ST. LOCALITY /`jK� �I DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST T S CROSS ST. �/ RECEIVED BY Ready for Inspection DATE ISSUED OWNER /is� �(S'7",�-t�� 7 ,��i h,,� • �+'4 MAIL DRESS 3 �� C/r'�e� /T! �i ADDRESS f9 USE ZONE I OCCUPANCY I MAP BK PG CITY .NO. CONTRACTOR I , �, CO.IMP.NO. ADDRESS 3 ��/ /C•7C/ )OB NO. CITY zpAbJ� TEL.NQD,D 75J.11 TRUNK PERMIT NO. STATE' REGISTRATION NO. y 10/6 COUNTY ROAD PERMIT N0. LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT PERMIT NO. BLOCK /l TRACT S�� Xv/7-4 AAAA , INDUSTRIAL WASTE PPROVAL SIZE OF LOT f,5_4 ,J'TJ NO.OF BLDGS. 'a NOW ON LOT CHARGES USE OF BUILDINGS D, CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TOREIMBURSEMENT FEE PUBLIC SEWER $ 3.50 RECEIPT NO. DATE I BY HOUSE SEWER CONNECTING TO PRiVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR T EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING 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 PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYW ELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LOWER- TYPE OF CONNECTION LENGTH FROM " OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION TOTAL FEE O I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE SIGNED THIS ------__._____.DAY OF-- .--.'. --_..-.I9A. NEW HOUSE SEWER OWNER ORCONNECT ADDITIONAL OWNERS AG ....-. BUILDING OR WORK 3 -------- ----- ------------------- SEPTIC TANK,SEEP.PIT(S) ADDRESS..........._.........._...........-------------------------• --------------•--------- AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL❑ DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDENANCES AND STATE LAWS ALTER, REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT IAM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SIGNATUReSEEP.PIT(S)[-] CESSPOOLS OF PERMITTr e----------------- _------- 76A642D 663 1/53 TEMPLE UTY 7f1441D APPLICATION FOR PERMIT COQ °F' zos SEWER-SEWAGE DISPOSAL 1 DUAHTMIUVT OF COUNTY Ery BUnXQq(i AHD SAF= DrIMON BUILDIMGTcmf , ''� ADDQESE 0 11 of is LocAUTT XEARESI � FOR APPLICANT TO FELL IN ST LEGLL DESCRI-MOX IAT N0. O 4LOCK . TRACT MAIL ADDRESS NO.OF BIAGS. SIZE OF LOT XOR OX LOT CITY NO. USE OF BUILDING DI JCT NO, 74, LAP PROCE3S1�BY CONTRA ` +� ADORE" J/ COMM=ON DATA cmikTEL NO. f OR DEPTH ATEMANHOLE REFERENCE UPP REGISTRATION no. COUNTY 110 ry �7EE CE��R PUBUC SE7ERCORNECTIEG TO O t3.0,0 TYPE OF COXX OX LEIIGTH FROM SEPTIC T K,SEEPAGE PIT OR T. P M.L.TO P PITS AND/OR DRAINFIELD MMSWAGE PIT DRAIXFIELD ESSP00 D OUSE EWER CONXECTI G P.C.X0. 1�y CO,tLP.X0. }OB X0. BORE TO HOUSE QUAL BLDG.OR TRUNK PERMIT X0. RDAD PERMIT L0. %AI OSEWPAAXDOX HOUDH STATE ENCROACHLEXT 100 PERMIT NO. IN HIAL W APPROVAL CHARGM OWNER'S PE"GT 2 00 CDXNECnON CHARD[FEL AUTSORMATION TOTAL FEE e L16 REIYBURSE■ENT PFA 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED COX- TRACTOR TO CONNECT THE ABOVE DESCRIBED PUSTING DWELLING APPROVALS DATE IN$PHCTOR'S 374XATURE TO THE PUBLIC SEWEL SIGNED THIS nAY OF Igo NEW HOUSE SEWER — OWNER OR CONNECT kDDITIONAL OWNERS AGB2ff BUILDING OR WORK ADDRXS3 SEPTICTANK, ELDPIT(3) I HERVT ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION AND STATE THAT THEE AggOVH 13 COfECT AND AGREE TO COMPLY CESSPOOL DRYWELL WITH ALL COUNTT ORDIXAMCES ACID STATE LAWS REGULATING ALTER,REPAIR SEWER OR PLALgIXG AMD SHfFR9 SEWAGE DISPOSAL STMM 1 HEREBY CERFT THAT 1 AN PROPERLT REG STERED AND/OR DISCONNECT PLUG AND LICTIENSED AS REQUIRED BY LOS AMGELED COUNTY AND STATE OF ABANDON HOUSE SEWER CAL FO RX IA OR TIJAT I A■ THE LEGAL ER OF TEX AKVH C I DFSBED REBID PEIITT BACE PLT S C TAN" SIGNATURE SEE- !!dd$$ OF P VALIDATION wa ROBERT A. bD DL L 0. -sm Mupwrir HINQ HECfiAmcA1., kNO1NMiat L _ 4 5 5a M 5 i O .p 5.0 0 f - `_'°" 7r2.42o APPLICATION FOR PERMIT COUNTY OF LOS ANGUM SEWER-SEWAGE DISPOSAL 1 DEPAMMU OF COUNTY MW= BUMDING AND SAFETY DnrMON AUILDINa AADREds r OH2f A. r�v*tr Com Fla..: a. JE f, eayt o3 HrULOCw YT NEAREST FOR' APPLICANT TO FILL IN CROSS LEGAL O DESCRIPTION LOT N0. OW NRR BLOCK TRACT -PAIL ADDRESS X0.OF BLDGS. SIZE OF LOT NOW ON LAT [M" USE OF DI T NO. GROUP MAP BT BUILDING D[ F9 CONTRACTORLi ADDRESS d2 ONN=ON DATA Cm LN . DIFTE TE REFRItENCYUPPER REGISTRATION 110. COUXTT NO. O DESCRIPTION 7�sESCR CONNECTING TO FEE .� ` PUBLIC IW"ER TP[ OF CONNECTIOM LJiXGTII FRO[ SEPTIC T/1N K,SEE-PAGE PIT OR CURB P. IT TO PL. PI TB AN OR DRAINFIELD OYERFL.OW SEEPAGE PIT,DRAIIIIELD - L. 00 OUSE SEWER CONNECT G TO P.F.NO. P. NO. JOU N0. CONNECTADDITIONAL BLDG.OR CORK TO H TRUNK PERMIT MO. ROAD PERMIT w0. lEWFl{ T R, EPA IR OR BANDOX HOUSE STATE ENCROACHMENT _ PERMIT NO. INDUSTRIAL _ WAST9 APPROVAL CHA-RGES QWNE3rs PEMMn COIINRCTION CHARGE FEE AUTHORPLATION I TOTAL FEE REINBURSENE11T Fpj RAVE AT S DATE TEECBEDREIN DECON- TRCTOTO CONNECT HE ABOVE DESCRIBED EUS ING WWG APPROVALS DATI - INSnCTOR'S SIG"TUR>< TO THE PUBLIC fEWElL. SIGNED THIS nAY OF 19- NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGE]IT BUILDING OR WORK ADDRE32 LA AX K,SEEP.PITS) DRAINFIELD I HEREBT ACKNOWLEDGE THAT I I{AYE READ THL" C-AON AND STATE THAT THE ABOVE IS CORRECT AND AGLTL DRTWILL WITH ALL COUNTY ORDINANCES AXq STATS LA1/ GEPAIR,SEWER OR PLUMBING AXD SE1•ERf. DISPOSAL SYSTEM I HERB BT CERTIFY THAT I A■ PROPERLT REGIORECT PLUG AXD LICENSED AS REQUIRED BT LQS AXGEL.FJ COUNTYOFN HOUSE SE71Ei1CALIFORNIA OR THA I A■ THE LEGAL OWN VE DESCRIBED REBID PROP 8 C TANKS _ SIGNATURE IT S CEEB OF PERMIrrEg m. VALIDATIONROBERT A. WOOD QL L 0. DUPMVISIN0 MECHANICAL MN01ROMt L,09 4 5 62 DEC 5 1 1 Q 2 5.0 0 !