The URL can be used to link to this page

Home My Public Portal About5458 LOMA AVE_Sewer__ i DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDiNO —� ADDPc83 � c� FOR APPLIC IN LOCALITY j��YJD�t G i DDRESS `� r r i� / /� NEAREST ACROSS ST. U LOCALITY DISTRICT N0. SERIAL N0. PERMIT N70.(� C NEAREST ' F�.� �� A .� ,.� / d J CROSS ST. _ RECEIVED BY Ready for Inspoetlon DATE ISSUED OWNER Zy✓yiL ADDRESS r r� USE ZONE OCCUPANNCY BK MAP PB CITY v TEL.N .I CUNTRACTOR )•- �f �_ � CO.IMP.N0. 7 2 ADDRESS r'r JOB.NO. CITY L TEL.N0.� ��/� �O/'j TRUNK PERMIT NO. REGISTRATION N0. 7 COUATE NTY ROAD PERMIT N0. LEGAL ! STATE ENCROACHMENT DESCRIPTION LOT N0. PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT Onn r� NO.OF SLOGS. l f / . NOW ON LOT CHARGES USE OF �^ BUILDINGS/ �,, , j-" ,^1 �;_ a CONNECTION CHARGE FEE N0. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE- /�"- - -- HOUSE SEWER CONNECTING TO r PUBLIC SEWER ! 3 3.50 RECEIPT NO. _"-bATE BY HOUSE SFWER CONNECTING TO —r— PRIVATE DISPOSALSYSTEM 1.00 _ CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO I DATE SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AHD/OR DISPOSAL SYSTEM 1.00 I CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR ^-) i DEPTH ^ PITS ANO.OR ORAtNFIF1.D 2.00 STATION �, _L CESSPOOL—DRYWELL --- "'-- SPECIAL CONDITIONS ONLY 2.00 (,� (MANHOLE REFERENCE - UPPER TYPE OF CONNECTION LENGTH FROM -Y- CURB M.L.TO P.L. OWNERS PERMIT $ I 1 00 AUTHORIZATION TOTAL FEE IHAVE CONTRACTOIS DATE R TO CONNECT THE ABOVE DESCRIBEED WITH THE D EXISTING AED PPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS-_._!___. .DAY QF.. _,,� JLAWS -•• NEW HOUSE SEWER CONNECT ADDITIONAL OWNER OR Ji%;`J�,..�r-�f�vBUILDING OR WORK OWNERS AGENT....... 1r�...L,.rG-d- _:. ..,.-._.�. SEPTIC TANK,SEEP.PIT(S) ADDRESS.......... ....._:....._.-...........-.-........_................_....-_.._.. _... AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THILI- CESSPOOL Il DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT ANEE TO COMPLY WITH ALL COUNTY ORDINANCES AND STAS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1HEREBY CERTIFY THAT I AM PROPERLY REGED DISCONNECT PLUG ANDAND/OR LICENSED AS REQUIRED BY LOS ANGELESTY ABANDON NOPLUGANDUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPEBACKFILL SEPTIC TANKS SIGNATURE �r SEEP.PIT(S)E] CESSPOOLS . _.- OF PERMITTEE.. . ....... arta I/Ms DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES _ WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS \ •D �.'�� , ._/l.` — C� FOR APPLICA LL IN LOCALITY BUILDING NEAREST ADDRESS )/ CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. .. 1 PERMIT NO. NEAREST A I L~� '.- S CROSS ST. RECEIVED BY Ready for Inspection - DATE ISSUED OWNER �L MAIL ADORESS1 USE ZONE OCI"PANCY �K MAP PA CITY TELAO. CONTRACTO/R, f At! yz �CrC� '� CO.IMP.N0. , ADDRESS �I/'�/ �_ ��if JOB.NO. CITY / TEL.NO—.—h D �! TRUNK PERMIT NO. REGISTRATION NO. g iC COUNTY I - ?S - � ROAD PERMIT NO.LEGL VESC.4APT!CX _OT NO. � STATE UNrt1OACPMErT ---- PERMIT N0. BLOCK TRACT -��'/J INDUSTRIAL - WASTE APPROVAL SIZE OF LOT ' - 1 NO. F BLbGS. � CHARGES _ NOW ON LOT USE OF r BUILDINGS CONNECTION CHARGE�EE No. DE13CF41PTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO _ PUBLIC SEWER 0 } 1.50 RECEIPT NO. I ` DATE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 ' CONNECT ADDITIONAL BLDG.OR EXCEPTION 0ECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. DAT$ BY --SEWER OR DISPOSAL SYSTEM_ 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DA SEPTIC TANK,SEEPAGE PIT OR \ PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYW ELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LOWER _ TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ I I 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED rONTReCTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER - ' •�• NEW HOUSE SEWER SIGNED THIS... ' ...DAY OF............3-.--.--..._..__.._19 OWNER OR / j,/ CONNECT ADDITIONAL OWNERS AGENT.`^.. ._---- BUILDING OR WORK �+ SEPTIC TANK,SEEP.PIT(8) ADDRE88./ _ N. .�a AND/OR DRAINFIELD TTT"" �_.................-. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL I] 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 1 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 CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS Ej SIGNATURE SEEP.PIT(S)E] CESSPOOLS OF PERMITTE � .- - - - ............- Y~ f -77