HomeMy Public PortalAbout9454 LAS TUNAS DR_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
AND SAFETY PERMIT APPLICATION
DIVISION OF BUILDING A
COUNT' OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS Alw
FOR PPLIC T 11L i LOCALITY /j �/�
BUILDING �fif CROSS STNEAREST. (( wtpi
ADDRESS
LOCALITY DISTTRIICT NO. SERIAL NO` PERMIT NO.
NEAREST AV �� 70 cCROSS STJREGEIV D BY� Ready for Inspection DATEISSUED
OWNERMAIL USE ZONE OCCUPANCY -MAPADDRESS , I(CITY TEPG
L
L;
CONTRACTOFM C. Nottingham Co. of Temple City CO.IMP.NO. /o "c�
ADDRESS 5933 N. CLOVERLY AVE. JOB NO.
CITY TEMPLE gkVN fALIF. � t -
r ! TRUNK PERMIT NO.
STATE
REGISTRATION N0. COUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. } s- PERMIT NO.INDUSTRIAL
/ /
BLOCK TRACT 6�6 WASTE A PROVAL,t:,)-�+t1r��,;�Irl 4. , f
SIZE OF LOT NO.OF BLOCS.
NOW ON LOT CHARGES
BUE DINGS Al 4 ` CONNECTION CHARGE FEE
NO. DESCRIPTION OF W '71< FEE �^
REIMBURSEMENT FEE
HOUSE SEWER CONNECTING fy
PUBLICSEWER @ $ 3.50 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO ` s
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 I.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 �A DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MAN H E7RENC
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 - - � P,L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE 1 :4 16-
litf�1.tJ
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNE�THE ABOVE DES IBED EXISTING APPROVALS INSPECTOR' SIGNATURE DATE
DWELLING TO THE P SEWER
SIGNED THIS- '�___.�- AY OF -.--- •.` _--------I NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL V
OWNERS AGE T - BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS.-.-
---- ---- -- - - -•------------ ------ AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I H E READ THIS APPLI- CESSPOOL E] 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 IAM 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 RESIDENTIAL PROPERTY. BACKFILL SEPTI TANKS
SIGNATURE � {�, SEEP.PIT(S)�. "@"ad M
OF PERMITTEEM--`'_-�lolingham Co_of TemPle Gity
76A642A 663 7/53