HomeMy Public PortalAbout9903 HOWLAND DR_Sewer__ DEPARTDfENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETYpPLI rilON<
COUNTY OF LOS ANGELES PEl�bll
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
CASSATT D. GRIFFIN, SOp•T OF BDILDING ADDRESS• :Fs Ile
BUILDING `FOR APPLICANT TO FILL IN LOCALITY Ta.�Tl ,n/P_ (ti
ADDRESS `3�O (�'//.f„L�iJI GROSS ST. -110 /� I'I
/i�,a" sf
LOCALITY '� ^ �� DISTRICT NO. SERIAL NO. ?PERR`MIT NO.
NEAREST yl�'•/ IA,IIe / \ .J A c7(O�3 J -� � ^ S
CROSS ST.
RECEI;EDAY Ready for Inspection DATE ISSUED
OWNER ' / 4t TL''L
ADO KESS.S,3�� G j1',p,U, USE ZONE OCCUPANCY RIS MAP PG
CITY OIFTELAO.
CONTRACTOR , ' , CHARGES REIMBURSEMENT FEE
/7
ADORES$,?} .r�yyLs.�� / REQUIRED ` ol,
..//// NOT REQUIRED /7\
CITY � � �• T� TEL.NO.y`/' G��•+}y 10. CONNECTION CHARGE FEE
REGISTRATION NO. / STATE
bG�L3/ COUNTY CO.imp. N0.
LEGAL RECEIPT NO. DATE_—_ I-
-BY
DESCRIPTION LOT NO. 2- ?i "-
BLOCK TRACT 713-1 WAIVER FOR RECORDING
NO.OF BLDG .
SIZE OF LOT16;7,A--G/f NOW ON LOTS / RECEIPT NO. I DATE I BY
USE OF /J
BUILDINGS
NO. DESCRIPTION OF WDRK FEE TRUNK PERMIT NO.
HOUSE SEWER CONNECTING TO �J
PUBLIC SEWER @ $ 3.50 S'� ROAD PERMIT NO.-.2:? 3A
HOUSE SEWER CONNECTING TO STATE ENCROACHMENT
PRIVATE DISPOSAL.SYSTEM 1.00 PERMIT NO.
CONNECT ADDITIONAL BLDG.OR INDUSTRIAL
WORK TO HOUSE SEWER 1.00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00
SEPTIC TANK,SEEPAGE PIT OR STATION B DEPTH
PITS AND/OR DRAINFIELD 2.00 MANHOLE REFERENCErn LOWER e
CESSPOOL—DRYWELL - ']'9 (r�
SPECIAL CONDITIONS ONLY 2.00 I TYPE OF CONNECTION LENGTH FROM 3 r, /
CURB —P-L,., M.L. L.
OWNERSI PERMIT S I OD uI O )1 r•
AUTHORIZATION TOTAL FEE (/ .4'0
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 SEWERR
SIGNED THIS....!:3__.....DAY OF 012 NEW HOUSE SEWER %,,_.. /�,�/ 13✓.S�'
OWNER OR ^`�, CONNECT ADDITIONAL
OWNERS AGENT _.. ___..-...-- /" BUILDING OR WORK
......................�.....t '...... .__..--
SEPTIC TANK.SEEP.PIT(S)
ADDRESS ?LC,._-. ....................... AND/OR AND/OR DRAINFIELD ,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL DRYWELL �'// �� }
CATi ION AND STATE THAT THE ABOVE IS CORRECT AND AGREE �, a •^��="
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER
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 HOUSESAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE yT SEEP.PIT(S)0 CESSPOOLS
OF PERMITTEE.�....r.......-_..__.._...........C ......
7CA642D 663 38/52
86520
CEeoej-ea -� APPLICATION FOR PERMIT 1
ccS
COUNTY OF LOS ANGELES EWER—SEWAGE DISPOSAL
DEPARTMENT OF COVNTY ENGINEER
BUILDING AND SAFETY DIVISION BDI LDING �.� ?
JOHN A. LAMBIE, County Engineer ADDRESS .J
CASSATT D. GRIFFIN. Supt of Building LOCALITY C.e
NEAREST
FOR APPLICA�]NT TO FILL IN CROSS ST: �J
LEGAL
DESCRIPTION LOT NO. <` J� OWNER �p�'O JO's//
MAI
BLOCK TRACT /_. / �� A DRESS ,f:/r
/ s�
NO,OF BLDGS. j/ .c
SIZE OF LOT — O /J� V NOW ON LOT CITY ./71 .) Ly' EL NO. � ✓ ��
16
USE OF
BUILDINGS DISTRICT N0. GROUP MAP PROCESSED BT
CONTRACTOR
BK PG
r c �
ADREss .� CONNECTTON DATA
CITY TEL. NO. 11TATE
STATION - DEPTH
REGISTRATION NO - MANHOLE REUPPER
NO. DESCRIPTION OF WORK FEE LOWER
HOUSE SEWER CONNECTING TOPUBLIC SEWER $3. - TYPE OF ONNECTION ..LENGTH FROM
PITS IAND/OR�RAENFGELOIT OR (9 $3. Y. 'CURB P.L. M.L.TOP.L.OVERFLOW SEEPAGE PIT, DRAINFIELD
E%TN.,CESSPOOL,DRYWELL,MANHOLE (N $2.HOUSE SEWER CONNECTINGTO NO.
PRIVATE DISPOSAL SYSTEM @ $1. CO.IMP.N0. JOB N0.
CONNECT ADDITIONAL BLDG.ORTRUNK PERMITN PERMIT NO.
WORK TO HOUSE SEWER @ $1.
ALTER, RE4MRBR••ks#MCON HOUSE STATE ENC ACH MENT
SEWER M @ $1.00 PERMIT W.
INDUS
WASTE APPR AL
• CHARGES
OWNERS PMIT $ 2 00 CONNECTION CHARGE FEE
AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT THE G DWELLING APPROVALS DATE 'INSPECTOR _
ABOVE DESCRIBED E%ISTINh ECTOR'S SIGNATURE
TO THE PUBLIC SEWER.
SIGNED THIS DAY OF I B— NEW HOUSE SEWER .I
OWNER OR CONNECT ADDITIONALAj' B
OWNERS AGENT BUILDING OR WORK
ADDRESS SEPTIC TANK,SEEP, PIT(S) �,o I ^
AND/OR DRAINFIELD i{
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION �'� ° _j/�,
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL EJ DRYWELL ❑e. It/P
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR �d'—1.
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM V
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/DR DISCONNECT PLUG ANDO'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE B VE
DESCRIBED RESIDEU71 ROPERTY. I BACKFILL SEPTIC YANKS ❑
SEEP.PITS [OC E$SPOOLS ❑
SIGNATURE
OF PER.....T A_
®. VALIDATION ROSERTA.WOOD
CK. M.o, CASH SUPERVISING MECHANICAL ENGINEER
LACo 9 5 7 21; JUL 1 6 1 0 8 3 .0 0 ��