HomeMy Public PortalAbout10644 LIVE OAK AVE_Sewer__ -,_EPA1trMZNT OF COUNTY ENGINEER SEWED—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
IWILLIAM J. FOX, 'COUNTY ENGINEER BUILDING f / ,f
ADDRESS � �• LI✓E A) .
FOR APPLICANT TO FILL IN LOCALITY fti7�Ab,fl
BUILDINGr / NEAREST -/
ADDRES� � L I � r L I VFX �V� CROSS ST. /Qr L / 4AIr,F ✓YE
LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO.
D/a. �'3
NEAREST S
CROSS ST. /�P�� �Q/�r ,�Jf� RE IVEDfBY Ready fo Inspection E ISSU D �/
OWNER (lee MAIL /l l//�TTE��Q� � .S T
/o%r,Cl,G/� G/�E �d� /��4r� USE ZOtyF� OCCUPANCY f ' BK PG
AP
ADDRESS p
CITY Aro, UlI� TEL.NO. AO'I�9/� / ���• I an
CONTRACTOR �1i�/jU/�,p
CO.IMP.N0.
ADDRESS JOB NO.
CITY TELAO. TRUNK PERMIT NO.,
STATE
REGISTRATION NO. 8 COUNTY- ROAD PERMIT NO.
LEGAL - ENCROACHMENT
DESCRIPTION LOT N0. (> (��CL� �'".3 .7�. PERMIT NO.
BLOCK TRACT ,A/ DDI' INDUSTRIAL
ypSTE APPROVAL
30� CHARGE
SIZE OF LOT ��jj ??{� NO.OF BLDGS..S 11 dNOW ON LOT 2t
USE OF
2)1 WEuihds
BUILDINGS � CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
--'HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
-PUBLIC SEWER $ 3.50 - 'ti-1 RECEIPT NO. Dk1TE BY
HOUSE SEWER CONNECTING TO
_ PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR -EXCEPTION REC DED
' WORK TO HOUSE SEWER -- 1.00
ALTER OR REPAIR EXISTING / NO. DATE \ I BY
_SEWER OR DISPOSAL SYSTEM 1 00
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD` 2.00 STATION 3 �SQ, DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE_REEEHENSE
---��L-0 W E R_
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 I
Y. CURB P L. M4TO P.L.
AUTHORIZATION I 'TOTAL FEE QQ ��T�OiC//9G
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS_____........_..DAY OF-------_----_----—--------._....19...... NEW HOUSE SEWER
o
OWNER OR CONNECT ADDITIONAL ¢� 9-
OWNERS AGENT-----------_------__ BUILDING OR WORK SG 6'L
SEPTIC TANK,SEEP.PIT(S)
ADDRESS ________________.-__._-------------------------------- •------------•- AND/OR D RA I N F I E L D
- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[3 DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY-WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ABANDON HOUSE SEWER
ER-OF THE ABOVE DESCRIBED RESIDNTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE �D // SEEP.PIT(S)[:] CESSPOOLS E]
OF PERMITTEE___ *__ � 1_.._._�__...__.
76A642A 663 7/53 f /
DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
..-DIVISION OF BUILDING AND SAFETY r; PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGBUILDINGINEER ` ADDRESS
FOR APPLICANT
TO
- LOCALITY
BUILDING / Q NEAREST
ADDRESS ^7/* CROSS ST.
LOCALITY DISTRICT N0. SERIAL N0. PERMIT N0.
NEAREST L4/1 -- s A
CROSS ST.
y �CEIVED BY Ready for Inspection DATE ISSUED
OWNER
MAIL USE ZON OCCUPANCY MAP
ADDRESS BK PG
CITY TEL.NO.
CONTRACTOR CO.IMP.NO. �
ADDRESS 8 JOB.NO.
CITY TRUNK PERMIT NO.
REGISTRATION NO. Y L ST TE
COUNTY ROAD PERMIT N0.
LEGAL3'O 8TATE ENCROACHMENT
DESCRIPTION LOT NO. %� 3:;k. V,/`15 F-y):. PERMIT NO
BLOCK TRACT J �^� J INDUSTRIAL
NO.OF WASTE APPROVAL
SIZE OF LOTL)-3 Ox 7,6 NOW ON LOTS
CHARGES
USE OF , '-^-
BUILDINGS QLGFJ"/ CONNECTION C E FEE
NO. DESCRIPTION OF WORK FEE
REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLICSEWER $ 3.50 RECEIPT NO. ATEI^BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER Loo NO.
ALTER OR REPAIR EXISTING I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR II I
PITS AND/OR DRAINFIELD 2.Q0 1 STATION 3-} DEPTH I
CESSPOOL—DRYW ELL
SPECIAL CONDITIONS ONLY 200 I 1 1 WHOLEtREFERENCE
Y TYPE OF CONNECTION M.L.TOHPFROM �S
OWNERS PERMIT $ I I 00
AUTHORIZATION TOTAL FEE I -4d 50
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWE��R,,����^
SIGNED THIS-_ .._....._DAY OF.<1� ._.__._.._..____19L'J_ NEW HOUSE SEWER Se- ,,io G� a-��•-I��
CONNECT ADDITIONAL
OWNER OR /L , BUILDING OR WORK
OWNERS AG NT. _.__...............-_--._-_
SEPTIC TANK,SEEP.PIT(S)
ADORE S129- /...................... AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL[:] DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR.SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I 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 CA I RNIA OR HAT 1 AM THE GAL OWN-
ER OF THE ABOV SCRIBE ESIDENTIAL P PERTY. f BACKFILL SEPTIC TANKS _
NATURE
SIG1`/�/�A-I SEEP.PIT(S)o CESSPOOLS
`~
OFPERMITTE ......... ....................... -•-...................................
76A642D 663 1/53 r� G