HomeMy Public PortalAbout9514 LAS TUNAS DR_Sewer__ DEPAKTMENT OF COUNTY ENGFNEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES BUILDING ' VA
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WILLIAM J. FOX, COUNTY ENGINEER A,DDRESNS' 6
FOR APPLI ANT TO//FILL IN LOCALITY f FBUILDI . ►G® �'
ADDRE S ac.C�,f/L/id//f CROSS ST.NEAREST
LOCALITYDISTRICT 0. SERIAL N0: PERMIT NO.
NEAREST
J / %/ c
CROSS ST. �J0 e2 A J
RECEIVED BY Ready for Inspection 'DATE ISSUEE6
OWNERMAIL
ADDRESS�elew USE ZONE 0�UPANCY BK MAP PG
CITY CP, TE L.N0. �. tom
CONTRACTOR
CO.CO.IMP. N0. � _'_..
ADDRESS via 'a e � r
iill JOB N0.
CITY' �TEL.NO.`�/! 4:g-3"x1 ' TRUNK PERMIT NO.
REGISTRATION NO �� COUNTY, ROAD PERMIT NO.
LEGAL /�< STATE ENCROACHMENT "
DESCRIPTION LOT NO. (y,p PERMIT NO. �'"--
BLOCK -TRACT ��'•"�, INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NOW ON LOTS CHARGES
USE OF ' ' =CONN,ECTIO . ARGEsFEE
BUILDINGS==�jj�J ?/!( `
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLICSEWER @ $ 3.50 RECEIPT NO. IBY
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 N0. I DATE IBY
_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 114 'q DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 /I���41 MANHOLE-REFERENCE
A` U'PPERJ UO;WXR
TYPE OF CONNECTIONS LENGTH FROM 42P
OWNERS PERMIT $ 1 00 Y. CURB P.L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTO54SIGNATURE DAT
DWELLING TO THE PU LIC SEWER
SIGNED THIS-• _'i.- DAY OF--� ---- NEW HOUSE SEWER L
OWNER OR CONNECT ADDITIONAL t
OWNERS AGENT__-.._.__ _.___ BUILDING OR WORK
.. -.��rz y.7
� 56 i -- / SEPTIC TANK,SEEP.PIT(S)
ADDRESS... ___ .�l--fit?......./.../..._4�-___--......___--- AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL 0 DRYWELL
CATION AND STATE THAT THE ABOVE 19 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 I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBEDIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E]
SEEP.PIT(S)E] CESSPOOLS ,,,, ^SY
SIGNATURE '� ,J, =
IG PERMITTEE __ a __
76A642A 663 7/53