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Home My Public Portal About6008 KAUFFMAN AVE_Sewer__ &E:6D 5 83 I1•D9 APPLICATION FOR PERMIT 8 8t E-8 ' DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Department 'of,County Engineer. • County Of LOS Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS. ® CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITYNEAREST FOR APPI!LCMT TO FILL Rj CROSS ST.' LEGAL ♦ OWNER -C - DESCRIPTION. LOT N0. MAIL BLOCK TRACT o 1 ADDRESS1 NO. OF BLDGS. q CITY TEL.NO.' SIZE OF LOT • ' NOW ON LOT �f/' USE OF FDISTRICT N0. GROUP MAP BUILDINGS _ , 2 BK /P 3G . CONTRACTOR � � CONNECTION DATA ADDRESS „i STATION •� DEPTH CITYTEL, NO. ,� ,MANHOLE REFERENCE REGISTRATI N0. /jj' ❑ COUNTY - NO. DESCRIPTION OF W EE HOUSE SEWER CONNECTING TO TYPE OF CTION LENGTH FROM / PUBLIC SEWER @ $3.50 CURB �i� M.L.TO 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 © $2.00 CO. IMP. NO. JOB N0. ' HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO. ROAD PERMIT NO. �3 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 $1.00 WASTE APPROVAL CHARGES CONNECTION-.CHARGE FEE - OWNER'S PERMIT 5.. 1 00 REIMBURSEMENT FEE - - AUTHORIZATION TOTAL FEE (� I HAVE AT THIS DATE-A CONTRACT WITH THE EREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE '- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO.THE PUBLIC SEWE NEW HOUSE SEWER SIGNED THIS � AY OF 19 CONNECT ADDITIONAL, OWNER OR. `- BUILDING,OR WORK OWNERS AG NT SEPTIC TANK,SEEP, PIT(S) ' ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1E READ'THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE•THAT THE ABOVE IS C CT AND AGREE TO COMPLY - - WITH'ALL COUNTY ORDINANCES STATE LAWS- REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM ' 1 HEREBY CERTIFY THAT*1 AM PROPERLY REGISTERED AND/OR DISCO ECT PLUG AND ` LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER )ALIFORNIA OR THAT J AM T LEGAL- OER OF THE ABOVRI$,FD fjID PROPE Y, BACKFILL SEPTIC TANKS❑CRM" SEEP. PLT(S) ❑ CESSPOOLS❑PERM T�'�"LGA�CLI �,•�'f'GG .F/'L - 5allaimilge VW" i Id 96990 1-14 JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG. INSPECTOR CK. II 0. CASH - - - •• 4 6 8 v- APR 2 4 45