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HomeMy Public PortalAbout9425 KENNERLY ST_Sewer__ DEPARTMENT OF COUNTY ENGUQ= SEWER—SEWAGE DISPOSAL. 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. ,FOX, COUNTY ENGINEER , BUILDING ADDRESS FOR APPLICAW To FILL IN LOCALITY t BUILDING NEAREST ADDRESS CROSS ST. LOCALITY DISTRICT NO SERIAL NO. PERMIT NO. NEAREST J, ) 1 ZZ O O —� CROSS ST. OCEIVED BY Ready for Inspection DATE ISSUED OWNER 4y .� ADDRESS'AIL USE ZONE I OCCUPANCY BK MAP PO / CITY ELNO. / CONTRACTOR dFW ADDRESS cvz ,— JOB.N0. �C O G® CITY �nTEL.NO. , ., TRUNK PERMIT'NO. 1 �e ❑ STAT �4 REGISTRATION NO. �f�y 6 �3 f� �� $'=TEY, ROAD PERMIT NO. LEGAL 0 STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK TRACT B � INDUSTRIAL WASTE APPROVAL SIZE OF LOT tj rNOW ON LOTS CHARGES O_OFUSE BUILDINGS 00%io�; O AR CONNECTIGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER @ $ 3.80 RECEIPT NO. A� IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSESEWER- 1.00 ALTER OR REPAIR EXISTING NO. DATE BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER 1 AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AHD/OR DRAINFIELD 2.00 STATION © , DEPTH CESSPOOLDRYWELL f MANHOLE=EFERENCE LOWER SPECIAL CONDITIONS ONLY 2.00 N W TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ I 00, .4688?- k' PT M.L.TO P.L. "� 0 AUTHORIZATION TOTAL FEE .'^ CONTRACTORHAVE TO CONNECT DATE THEED TOABOVE DESCRIBED IEXISTIN� APPROVALS INSPECTOR'SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS............_._DAY NEW HOUSE SEWER SG ank-_ 'a S OWNER OR CONNECT ADDITIONAL OWNERS AGENT•...•.•.-.._•._•._----•:--_- BUILDING OR WORK - - - �'-'+�- - SEPTIC TANK,SEEP.PIT(S) ADDRESS............... -•---._•..--._._...•_--_..-.•_.. AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL DRYWELL CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE-LAWS ALTER, REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. [ SEWAGE DISPOSAL SYSTEM 1 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 I AM THE LEGAL OWN• ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. `„ BACKFILL SEPTIC TANKS SIGNATURE 1 SEEP.PIT(S)E] CESSPOOLS OF PERMITTEE--45-'•-?'�. .'f- ._C^!. ._--�'.....- 76A642A 663 7/53