HomeMy Public PortalAbout8814 LAS TUNAS DR_Sewer__ SBAE-06 APPLICATION FOR. PERMIT
1
a9E-BeDIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Department ofCountyEngineer
County of Los Angeles BUILDING q-
RB1J E.
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS LAS UnaSI
® CASSATT 0. GRIFFIN. SVP'TOF BUILDING LOCALITY San Gabriel
FOR APPLICANT TO FILL IN CROSSSST. Muscatel
LEGAL �� OWNER .e
DESCRIPTION LOT N0. C'rpp1Pp.T1 Martin
BLOCK TRACT lM,n10 �r -�i ADMA IDRESS VH E. Las Tuna
��[ �W NOWOON LOT S
SIZE OF LOT I CITYSpn GabrielTEL. NO.At
USE OF L
Lj�=
BUILDINGS ib 0-4 DISTRICT NO. GROUP BK MAP //
CONTRACTOR L PlumbingCO� _-E7— /P�b
ADDRESS 715 E. Broadway CONNECTION DATA
U832_ _ STATION ♦ l DEPTH
CITY San Gabrie VEL. No. At. U832 MANHOLE REFERENCE / Sr PPE
(j STATE / . Y� (/r LiffWER
REGISTRATION NO. ❑ COUNTY
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TOTYPE OF CONNECTION LENGTH FROM
PUBLIC SEWER @ $3.50 Y. CURB P.L. M.L.TO P.L.
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/OR DRAINFIELD @ $3.00
OVERFLOW SEEPAGE PIT, DRAINFIELD > P. C. NO.
E%TN..CESSPOOL,DRYW ELL,MANHO LE @ $ 2.00
CO. IMP. NO. ! / JOB NO.
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ S LOO TRUNK PERMIT NO. ROAD PERMIT NO.
CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT
WORK TO HOUSE SEWER @ S [.Do PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ S 1.00 WASTE APPROVAL
CHARGES
OWNER'S PERMIT gCONNECTION CHARGE FEE
• �
AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS ATE INSPE TOR'SSIGN URE
HAVE
TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER. _ NEW HOUSE SEWER
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL
OWNER OR BUILDING OR WORK _
OWNERS AGENT
(� !, SEPTIC TANK.SEEP,PIT(S)
ADDRESS A I ! ',""1-0 AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICEN55D AS REOWREO BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE ,L GAL OWNER OF THE ABOVE
DESCRIBED R D TIAL PIIDXc Ty, SEEP. (S) [I CESSPOOLS Cl
SIGNATURE
OF PERMITT -�� '
JOHN A. LA I ."COUNTY ENGINEaVALIDATION„__'� ROBERT A. WOOD, CHIEF PLUG. INSPECTOR.
CK. M.0. 4tL AAlSu/
. , L ,8,4 JAN 30 4 A 45 0 M