HomeMy Public PortalAbout9917 HOWLAND DR_Sewer__ S&E-6D .AY P�pCA Y �OIIV . FOIIU 11' ERD1rY11 �T
S&E-663 11-58 � '
DIVISION OF BUILDING AND SAFETY SEYVER-SEWAGE DOSPOSAL
Depoxtment of County Engineer -
County of.Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
® CASSATT D. GRIFFIN, SUPT OF BUILDING - LOCALITY
FOR. APPLICANT TO FILL IN qC_R s
LEGAL' /i—V 0 � OWNER
All
DESCRIPTION LOT NO. � - '
BLOCK TRACT MAIL ADDRESS
?: SIZE OF LOT , / /NO. OF BLOTS CITY TEL. NO. .r .�
K, r,a f_'h..,.,� a.,R' .: :x ,rti• �'
. 'USE OF -
BUILDINGS DISTRICT NO. GROUP MAP
'
K PG
CONNECTION
ADDRESS• DATA
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CITY 'TEL. NO. a STATION T O -5
DEPTH -
° �� MANHOLE REFERENCE UPPER
O ' OW R
REGISTRAT/ N NO, _ - ❑ COUNTY
NO. DESCRIPTION F0 K FEE
TYPE OF TION LENGTH-FROM
HOUSE SEWER CONNECTING TO M.L. TO P.L.
PUBLIC SEWER @ $3.50 ,~ Y- URB P.L.
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD' Q $3.00
OVERFLOW SEEPAGE PIT,DRAINFIELD P. C. NO.- .
EXTN.,CESSPOOL,DRYWELL,MANHOLE c@i $2.00 CO. IMP. NO. �.J.O� JOB NO.
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSALSYSTEMa $1.00 TRUNK PERMIT NO. ROAD PERMIT NO, q 9,
CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT
.WORK TO HOUSE SEWER - @ $1.00 PERMIT NO. -
ALTER,,REPAIR OR ABANDON HOUSE _ INDUSTRIAL '
SEWER OR DISPOSAL SYSTEM. @ $1.00 WASTE APPROVAL '
CHARGES
CONNECTION CHARGE FEE ..
OWNER'S PERMIT 1 00
AUTHORIZATION' TOTAL FEE REIMBURSEMENT FEE
I HAVE'AT THIS DATE A CONTRACT WITH THE EREIN NAMED CON- _' APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNEC ABOVE DE RIBE EXISTING DWELLING {J
TO THE PUBLIC EW - 'NEW HOUSE SEWER
SIGNED THIS AY 0' I9 T '
CONNECT•ADDITIONAL ��^����
OWNER OR - BUILDING OR WORK . 'f9if.IA- •..71 '
OWNERS GEN
f, SEPTIC TANK,SEEP,PIT(S) .
• ADDRES q AND/OR DRAINFIELD' -
I HEAA , NO DGE THAT I RE T. IS APPLICATION r CESSPOOL❑ DRYWELL.❑
AND STATE.THAT THE ABOVE IS CO RE-T AND AGREE TO.COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING s ALTER,REPAIR,SEWER OR
PLUMBING' AND SEWERS. SEWAGE DISPOSAL'SYSTEM
I HEREBY CERTIFY THAT f 'AM PROPERLY REGISTERED AND/OR - DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES LEGAL COU TY AN STATE OF °• ABANDON HOUSE SEWER
,} CALIFORNIA R THA If AM TH 0 R OF� 0 ROP R g BACKFILL SEPTICTANKS❑ p�
y. �dGJ1�1lTffF2� q t?Y�s/ - SEEP. PIT(S) ❑ CESSPOOLS L '"✓4,,+
CfF PERMI E
JOHN A. LAMBIE,COUNTY ENGINEER VALIDATIO ROBERT A.WOOD, CHIEF PLBG. INSPECTOR
• CK. M.0. CASH