HomeMy Public PortalAbout9416, 9418, 9418 1/2 LAS TUNAS DR_Sewer__ ®I�J�o�gp��/� �(�y�® ppp��� - FOR
PERMIT
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DNISI�N OF BUILDING AND SAFETY SEWER®SEWAGE DISPOSAL.
bepcatment of County Engineer
County of Los Angeles BUILDING
WM.J. FOX,COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
LEGAL �J//�ry
DESCRIPTION LOT NO. OWNER BIT
BLOCK TRACT L/ MAIL .�
ADDRESS
NO. OF BLDGS.
SIZE OF LOT NOW ON LOT - CITY TEL. NO.
USE OF
BUILDINGS � � �1T DIST NO. GROUP .MAP
BK PG
CONTRACTOR X'_ Z -L f J
ADDRESS ') CONNECTION DATA
j '
CITY , TEL. NO.,4 0��L�Q � STATION DEPTH
UPPER
q ❑ STATE M HOLE REFERENCE
REGISTRATION NO. / 3 `9G'/ E3COUNTY re p en LOWER
NO. DESCRIPTION OF WORK FEE
TYPE C014NECTION LENGTH FRO
HOUSE SEWER CONNECTING TO Y. CNB P.L. M.L.TO P.
PUBLIC SEWER cr $ 3.50
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
0 CONNECT ADDITIONAL BLDG. OR P. C. Ue
'
WORK TO HOUSE SEWER 1.00 CO. IMP. NO, JOB O.
ALTER OR REPAIR EXISTING -
SEWER OR DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. OAD PERMIT NO.
DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT
AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO.
SEPTIC TANK, SEEPAGE PIT OR g
PITS AND/OR DRAINFIELD - 3.00 INDUSTRIAL _
CESSPOOL- DRYWELL WASTE APPROVAL
SPECIAL CONDITIONS ONLY 2.00 CHARGES
- CONNECTION HARGE FEE
PERMIT - `
OWNER'S s 1 00
AUTHORIZATION I TOTAL FEE REIMBU EMENT FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING „✓, APPROVALS DATE INSPECTOR'S SIGNATURE
TO THE-PUBLIC SEWER
SIGNED THIS -DAY OF 19 NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT _
BUILDING OR WORK I
SEPTIC TANK,SEEP, PIT(S)
ADDRESS 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER
DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑
SEEP. PIT(S) ❑ CESSPOOLS❑
SIGNATURE .,�t►G ys•r-� '
OF PERMITTEE
WILLIAM J.FOX, COUNTY ENGINEER VALIDATION R.A.WOOD, CHIEF PLBG. INSPECTOR
i_�Co 6.3 1. 4 N MAY 2 4 4 2.00 .
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