HomeMy Public PortalAbout8806-8808 LAS TUNAS DR_Sewer__ .7s?1N>F�iC't jM= Jii
]6A6<1D : 'APPLI'CATION F.OR PERIMfT 1:.
S L E=869 11.55
4. DIVISIOIN,OF BUILDING AND SAFETY S_E,W1ER'',;�$EWAGE,DJ;SPOSAL
f r T. Dep�tment of County Engineer ��
'`F 1 +. Couay of Los AageleBr�„', eDlry � •'as” I.) `. '. a
f ADDRESS I I%
6 'JOHNIA LIAMBIE COUNTY ENGINEER a > �yA�y�,,
I® T _ ��IaGAEAT_& GRIFAFy1 Nw 3,auP a ILOINcs _ .t,Y �LO CAL411 Tf .y,y,C'" j� jt"AI' t '�
AP,,PL_ICANTtT00FIIL'IN CRO SIsTat
LEGAL 1 1 ..c. - ., ,,ly,,,,,}���• ti r -� --
.DESCRIPTION . LOT�'N0 41�� T 1 .OWNEN i 'tlTY•`•"kAil�S/}rt'� 1-�"�i�5%K L=R •,
BLOCK TRACT -J to i:/� - AO RESSpp BOe`1 6T 'T' La�� 7 �•r/.) ('�
'1 .` O::OF BLOCS. CITY .W(�1::.-" t EL'S NO.' �fJ�•','T,
e51ZE OF'.LOT - NOW.ON LOT - `
USE'OF __
GBUILDINGB DISTRICT N'O..". GROUP MAP
-YCONTRACTORjjL Cv 1 �p BK' / PG126
_
'I{ ? e s5' :CONNECTION. DATA
�.r 1 +�'f STATION : DEPTH
T ,TEL..No
{MANHOLE REFERENCE 440/ _ UPPER
.� TATE .i `y' LOWER'
ii .REGISTRA 0 N0:" %� A ❑ 'CO NTY
I INO. DESCRIPTIOO�RI FEE �d
TYPE OF CONNECTI LENGTH FROM
.HOUSE'
SEWER CONNECTING G TO � -Y- CURB P.L.J(' M.L.TO P.L.
.PUBLIC SEWER'- @ S 3.50
SEPTIC;TA N K;iIEEPAG E,P I T OR
PI TS`AN 0/O Rlh R AINFI ELD. ''Q S,3.00
OVERFLOW SEEPAGE PIT;GRAINFIELD CO. IMP. NO. P. C.NO.
EXTN_CESSPOOL',DRY iELL,MAN HOLE- n $:2.00 o
HOUSE-SEWERCO NNECTINGTO '. -
PRIVATE DISPOSAL'SYSTEM. Q 81.00 TRUNK.PERMIT NO. _ ROAD PERMIT NO. _
CONNECT ADDITIONAL BLDG:OR '.STATE ENCROACHMENT
WORK TO HOUSE SEWER (u1 31.00 PERMIT NO.
I .ALTER•REPAIR OR ABANDON.HOUS_E
3 SEWER`OR DISPOSACSYSTEM' Q $1.00 'INDUSTRIAL -
I A, ..... "'WASTE APPROVAL• -
- CHARGES ,
CONNECTION CHARGE FEE '� U�
OWNER'S PERMIT s oo
'REI
AUTHORIZATION TOTAL FEE 5V MBURSEMENT:FEE
I I HAVE AT THIS DATE.A CONTRACT WITH THE HEREIN NAMED CDN- APPROVALS DATE INSPECTOR'SSIGNATURE
TRACTOR
y CONNECT THE ABOVE!DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWE NEW HO USE SEWER
EWER
SIGNED THIS�DCONNECTADDITIONALN_
AL
`J!{ ` 3
OWNEROR BUILDING R WORK
OWNERSAGENT X SEPTIC TANK, P�
SEEP, PIT(S)
i -
ADDRESS - AND/OR DRAINFIELD - -
1 HEREBY ACKNOWLEDGE THAT 1. HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑. -
ANDSTATE.THAT THE .ABOVE IS CORRECT AND AGREE TO COMPLY`
WITH ALL 'COUNTY ORDINANCES AND STATE LAWS REGULATINGALTER_REPAIR.SEWER OR•
PLUMBING AND SEWERS, - SEWAGE DISPOSAL SYSTEM.
I..HEREBY'CERTIFY' THAT I AM PROPERLY REGISTERED AND/OR DISCONNECTIPLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER'
CALIFORNIA OR jHAT I' AM.THE LEGAL,,OWNER OF THE ABOVE' -
DESCRIBED RESIDENTIAL PROPERTY. BACKFILLSEPTIC TANKS❑ - -
SIGNATURE .t o-, SEEP. PIT(S)❑'CESSPOOLS❑
OF PERMITTEE . : •-,.. �•. ,.r' .
JOHN A: LAMB .`COUNTY ENGINE ALIDATIOg ROBERT A: WOOD, CHIEF PLBG. INSPECTOR. --
. H 0 CASH _
;a5 Tso N"21 4 ti 4:5'�'