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Home My Public Portal About8835 LAS TUNAS DR_Sewer__ 1vAvaxo `EB°B'°` bJ81 APPLICATION FOR PERMIT SEWER -SEWAGE DISPOSAL COUNTY OF LOS ANGELES BUILDING AND SAFETY I FOR APPLICANT TO FILL IN DISTRICT NO.vI GROUP MAP FBO SED:BY BUILDING B/I ADDRESS yf }� CONNECTION DATA LOCALITY NEAREST STATION 'DEPTH' CROSSST. - _ UPPER _ MANHOLEREFERENCE, OWER' OWNER TYPE OF CONNECTION LENGTH FROM' 'MAIL Y. CURB P.L. M.L.TO P.L. ADDRESS •© _ G .. }" : NO. CITY L(, TEL NO. 7 �� CO. JO.IMP. NO. • ,LEGAL TRUNK PERMIT NO. ROAD PERMIT NO. DESCRIPTION LOTNO. AFFIDAVIT• WAIVER EASEMENT RECORD.INSTR.NO. GATE BLOCK TRACT NO.OF BLDGS. - SIZEOFLOT NOW ON LOT HWY.OR ST.WIDENING USE OF BUILDINGS STATE ENCROACHMENT PERMIT NO, •�� INDUSTRIAL CONTRACTOR Q WASTE APPROVAL ADDRESS / CHARGES -afCITY E (J TEL.NO. jj O CONNECTION CHARGE FEE N STATE LIC. REIMBURSEMENT FEE IL LICENSE NO. L{6 CLASS . - — NO. DESCRIPTION OF WORK FEE APPROVALS DATE INSPECTOR'S SIGNATURE u HOUSE SEWER CONNECTING TO 1 K PUBLIC SEWER "' - O SEPTIGTANK,SEEPAGE PIT OR.. NEW HOUSE SE WEfl A r PITS AND/OR DRAINFIELD CONNECT ADDITIONAL - /J HOUSE SEWER CONNECTING TO BUILDING OR WORK J PRIVATE DISPOSAL SYSTEM SEPTIC CONNE CT ADDITIONAL BLDG.OR A ANO/OR GRAINANK, FIELD SEEP.PITIS) WORKTO HOUSE SEWER-- - . lel ANO/OR GRAINFIELD OVERFLOW SEEPAGE PIT.DRAINFIELD CESSPOOL ❑ DRYWELL❑ E%TN„CESSPOOL.DRYWELL,MANHOLE _ ALTER.REPAIRORABANDO NHOUSE ALTER.REPAIR,SEWER OR SEWER OR DISPOSAL SYSTEM SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AN D ABANOO N HOUSE SEWER BACKFILL SEPTIC TANKS.[] . SEEP.PIT CESSPOOLS❑ OWNER'S Permit s U (� VALIDATION AUTHORIZATION' 'TOTAL FEE- I I HAVE AT THIS DATE A CONTRACT_WITH.THE.HEREIN NAMED CON- TRACTOR ON . TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. ' SIGNEDTHIS' - DAY'OF _ "19_ - - -- p'L /' n OWNER OR G J 4 3 A 1 OWNERS AGENT ADDRESS # 0 9'0 0 1 0 I HEREBY ACKNOWLEDGE THAT I HAVE READ THISAPPLICATION " ^� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 'Z 10 O 1 &O O WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '1 (� PLUMBINGANDSEWE HIS. — _ 4.Op 1 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR , 'O O O LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORN HAT 1 AM THE LEGAL OWNER OF.AND INTEND TO RE- BIDE IN,T EABO DESCRIBED RESIDENTIAL PROPERTY. Q.l 1 2� / - OF PERMITTE