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Home My Public Portal About5603 HALLOWELL AVE_Sewer__ IDEPAIVrMENT OF COUNW ENGINEER SEWER—SEWAGE DISPOSALDIVISION,OF BUILDING AND;SAFETY PERMIT APPLICATION ®� COUNW OF LOS ANGELESBUILDING } WILLIAM J. FOX, COUNTY ENGINEER ADDRESS FOR APPLICANT TO FILL IN LOCALITYBUILDING AEST DDRESS �7 i_Q �j >!i0 D� CRONEASS ST. LOCALITY -C _-lam )-14 _4N^ DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST /}� A /a d'I S CROSS 8T. RECEIVED'BY Ready for Inspection DATE ISSUED OWNER• MAIL USE ZONE OCCUPANCY MAP ADDRESS /j11 ! BK PG CITY ��61stsLs�� a_.d-EA. O CONTRACTORCallfornia S6Ter Const.CCl_ CO.IMP.NO. ADDRESS 1317 Colegrove Ave. JOB NO. CITY Montebello TEL.NDUNion 1-50 3 TRUNK PERMIT NO. ATE REGISTRATION NO.104445 Stet LINTY ROAD PERMIT N0. LEGAL B DESCRIPTION LOT N0. -STATE ENCROACHMENT Q PERMIT N0. BLOCK TRACT INDUSTRIAL WASTE APPROVAL � LOT SIZE OF LOT� y NOW ON OF S CHARGES USE OF �- A BUILDINGS 1�� CONNECTION CHARGE.FEE s- NO. DESCRIPTION OF WORK FEE __-N _ REIMBURSEMENT FEE �f HOUSE SEWER CONNECTING TO e�1 6J� PUBLIC SEWER @ $ 3.50 RECEIPT NO. 'DATE BY HOUSE 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 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 CESSPOOL—DRYWELL DEPTH SPECIAL CONDITIONS ONLY 2.00 /'6 01 MANHOLE EFERENC A. ,- LOWER TYPE OF CONNECTION LENGTH FROM// OWNERS PERMIT I 0k0 '— °N's" C P- M.L.TO P.L. 3 AUTHORIZATION I TOTAL 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 f a j J�'_�/19.��! NEW HOUSE SEWER SIGNED THIS.��_._.._._.DAY OF-- -._�-----/� OWNER OR CONNECT ADDITIONAL OWNERS AGENT_._ .. _.r... __ ....................._ BUILDING OR WOR1< 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 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, ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN. ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SIGNATURE �� l�il �, f1� SEEP.PIT(S)� CESSPOOLS I OF PERM ITTEE.s --��1!1�/ieC L-f_/ _ ___.................-....... y 76A642D 663 1/53 J 76A6420 APPLIC'ATION . I°OR PERMIT 1 •6 a!E•663 12.54 DIVISION OF BUMDING AND SAFETY SEWER-SEWAGE DISPOSAL Department of County Engineer �j County of LOB Angeles BUILDIADDRENG O S1 �iyl �O 4� OMITS WM. J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY mom HER= M FOR APPLICANT TO FILL IN NEAREST LEGAL �//� mac- �s CROSS ST. DESCRIPTION LOT NO. p a1J �j v (�Tj ' OWNER BLOCK TRACT AIL p DRESS NO. OF BLDGS. SIZE OF LOT .CS^v(J NOW ON LOT D CITY TEL. NO. USE OF BUILDINGS?) DISTRICT NO. GROUP I MAP �ry BK PG CONTRACTOR A �' �!., -(Nl% GI ADDRESS ' 1C"'��(:wl r/L ��'1 ' CONNECTION DATA CITY � � TEL. NO. S ION DEPTH -- ❑ STATE MANHOLE REFERENCE REGISTRATION NO. - ❑ COUNTY UPPER LOWER TYPE O ONNECTIONLENGTH FROM NO. DESCRIPTION OF WORK FEE Y. CU P.L. M.L.TO P.L. HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $ 3.50 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00_ CONNECT ADDITIONAL BLDG. OR V v _CO. IMP. NO. B. NO. WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. RO PERMIT NO. DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO. SEPTIC TANK,SEEPAGE PIT OR INDUSTRIAL PITS AND/OR DRAINFIELD 2.00 CESSPOOL-DRYWELL —"— WASTE APPROVA -SPECIAL CONDITIONS ONLY 2.00 CHARGES CONNE ON CHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION TOTAL FEE a(g) RF2KIRSEMENT FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTORS SIGNATURE TO THE PUBLIC SEWER NEW HOUSE SEWER ' SIGNED THIS DAY OF 19` OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK rp7 /1C/,�]Llst/[� L ` 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 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ 7 SEEP.PITS) ❑ CESSPOOLS❑ .SIGNATURE j OF PERMITTEE �, " �� Al a•._, WILLIAM J.-FOX. COUNTY ENGINEER VALIDATION 0`8-9 tis DEC 15 4 2:�J 4 BY _ . DEPUTY DEPUTY " BY BY '0 DEPUTY r DEPUTY