Loading...
HomeMy Public PortalAbout6339 LIVIA AVE_Sewer__ 76A6420 5&E'6eDIAPPLICATION FOR PERMIT 11-55 APPLICATION OF BUILDING ANSAFETY SEWER-SEWAGE 1 DISPOSAL Deportment of County Engineer County of LOS Angeles BUILDINGA�•L�,�j/� //1/G JOHN A LAMBIE, COUNTY ENGINEER ADDRESS �T Y�1� �/7Y/ ® CASSATT D GRIFFIN, SUPT OF BUILDING LOCALITY ✓�/ NEAREST �C OR APPLICANT T`'O FILL IN CROSS ST. OV G` LEGAL AI � ac OWNER p � � DESCRIPTION LOT NO �,R,�, Me R MAIL BLOCK TRACT` 'u ADDRESS 11C � Q J 7/ �p(!� SIZE OF LOT �QX / <J NOWOONBLOTS 1�CITY 0j-e (�/ r EL NO i USE OFLAr�I G A G BUILDINGS !/+G/L(i.fi ,r (� DISTRICT NO. GROUP - MAP BK �J PG 7 CONTRACTOR � Y ADDRESS dJJi � �`s' �� - CONN�E'CTION DATA f4 CITY TEL. NOZ Z) �� 4PC<k" MANHOLE © .J Q DEPTH MANHOLE REFERENCE <71 UPPER ❑ STATE REGISTRATION NO. ❑ COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTIO LENGTH FROM Y. CURB L M L TO P L f PUBLIC SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR " PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD P C NO. EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO. IMP. NO ! JOB NO HOUSE SEWER CONNECTING TO ' PRIVATE DISPOSAL SYSTEM @ $100 TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER @ $100 PERMIT NO ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ t 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT'FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER SIGNED THIS 4 DAY OF ZAP�e_ CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT / SEPTIC TANK,SEEP, PIT(S) ' ADDRESS N e �r AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIO 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _ DESCRIBED RESIDENTIA P OPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE ® , gSEEP. PIT(S) ❑ CESSPOOLS OF PERMITTEELila 466 JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK, M 0 CASH " 27 4.5 " t DEPAK•rnfENT OF COUNTY ENGINEER SEWER--SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES �y WILLIAM J. FOX, COUNTY ENGINEER BUDILDING RESS G �/ AD FOR APPLICANT TO FILL LOCALITY 7,0 �L BUILDING NEAREST ' ADDRESS CROSS ST. '/- /Y LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. a A 3879 s NEAREST J�-J CROSS ST. RECEJYJD BY Ready for Inspection DATE ISSUED OWNER ,rA" MAIL USE ZONE OCCUPANCY MAP✓ ADDRESS ' I � BK PG I CITY TEL. 0. CONTRACTOR /I CO.IMP.NO. oa. ADDRESS JOB NO. CITY /rTEL.NO. TRUNK PERMIT NO. l,, Q ❑ STATE REGISTRATION N j5 ❑ COUNTY ROAD PERMIT N0. LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO.8F BLDGS. NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLIC SEWER @ E 3.50 RECEIPT NO. I DATE I BY HOUSE SEWER CONNECTING TO - PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO- DATE BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AHD/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL ^ SPECIAL CONDITIONS ONLY 200 V MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE p 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 __ ------------ _. 9_._._ NEW HOUSE SEWER '�(i( (�- 7 OWNER OR CONNECT ADDITIONAL OWNERS AGENT. _ BUILDING OR WORK - SEPTIC TANK,SEEP.PIT(S) ADDRESS-----------•----•-- ------•-----....... ...•... AND/ORDRAINFIELD / 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSP00 Eq DRYWELL❑ / w I/!/r '� CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE / �: 111 kn TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 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 RES DENTIAL P OPERTY. BACKFILL SEPTIC TANKS Ej SIGNATURE �` -1-.. SEEP.PIT(S)Ej CESSPOOLS �i OF PERMITTEE---•---- --- ---MCI-••...-- -..... .... - - ' Fm 76A642D 663 1/53