HomeMy Public PortalAbout9636 LAS TUNAS DR_Sewer__ a e
I&E46 '11-55 APPLICATION FOR PERMIT
DIVISION OF BUILDING AND SAFETY SEWED-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUILDINGS
ADDRESS
JOHN A. L AMBIE, COLINTY ENGINEERa ��-- � J —
CASSATT D. GRIFFIN, SUP'r OF BUILDING LOCALITY
FOB. APPLICANT TO FILL IN CROSS ST, �'
LEGAL a �J
DESCRIPTION LOT N0.
Y OWNER ,�'°�`
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BLOCK TRACT - MAIL p- S.t a' y ✓• `' .
ADDRESS
NO OF i BLDGS. - :
SITE OF LOT - NCV ON LOT - CITY TEL. NO., -
USE OF -— -- ---- - �-.—
BUILDINGS DISTRICT NO, i GROUP i- MAP
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CONTRACTOR xy# .
CITY // IED. NO. L�rr DEPTH r v—
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MANHOLE REFERENCE =
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STATE
REGISTRATION NO. "� sS- ,,✓� - COUNTY
N6. f DESCRIPTION OF WORK: FEE -------------- --- ----
-- -- -__- ---_-_ ---_.-. _.--_- TYPE OF CONNECTIONLEN!TH FROM-----
SOUSE SEWER CONNLCI IN`TO �
;;;- L�' M L TO P.L.
PUBLIC_SNI SEWER a
.. Ca? �3.5 0! - -- --
SE.Pi IC TANK SEEPAGE PIT OR j
FITS ANL OR DPAINFIELD 4 $3-00
O iEluLUV S E EPA GE P1 OR INFIELD I L N4.
XTt ,CEScv'CJL,CRIv .� ,MANHOLE m 2,00 ` _C6. [MP, NOS., F,�. - Q6 NO�
_. STATE ENCROACHMENT
ENCROACN`�E;.NT
I.(),)HOJ E SEWER t ONNL TI`5-_ O � -- z✓��.�- ' = Aa..r a
PRIVY DISPOSAL SYSTEM �T S t.00 � TRUNK PERMIT NO, ROAD
',. C)rfNEC1 %CDITICNALBs.DG aR -- -- "`
WORK FO 40USE SE ER it S I. - PERMIT NO,
' ALTER,REPAIR OR ABANDON HOUSE - - --_-- --._---------.-_._--.—__ .--_ _ '-
AL
EW R O `p DISPOSAL S� TEM lu I.O� iNDU`E APP
L_ CHARGES
CONNECTION CHARGE FEE.- -
O'��I��FB,'S PERMIT � r� o:� ------
ll,, REIMBURSEMENT FEE
AUTHO rIZA T ION 1 OTAL FEE APPROVALS.AHED CON _. _l_. DOTE IINSPEC R SIGNA"CURE
I HAT, ,T T!{15 DATE CONTRACT J/I"fH i t£ HERE C ____---_-_- _._____ _
TR r'!C7 C•.R TO CONNECT THE ABOVE L'ESCRIk D. ':�:iS!'INa DWELLING � _--
1'0 T"h FJF!-L:C s f NLW HOUSE SEWER -
3 � t t-r «—. --tg'--C NFC DDi710N
OWNER OR — — — —
Ol^INtiR OR j� ` ., U!LL'hi, OR WORK
OWNFRS AGENT
8 a _ FPT'.0 TANK,SEEP P TIS �
ND/'CR DRAINFIELD ADDRESS_ I
I HE ESS` A KNeG ILEDC THAT 1 HAVE READ THIS APPLICATION i-'SS?c,>1..;,1 CG 'riELL l.J
AND STATE ThAT HE ABOVE IS CORRECT AND AGREE TO COMPLY —_ ---_ —_— ---_— �_-----._------
W11H ALL COUNTY ORDI";',,.CES AND STATE LAWS R£GU1.AT=, ALTER,REPAIR,SEWER OP--- �
PLtifiVG AND Sc4VERS. SEWAGE DISPOSAL SYSTEM
I HERE_I.Y i Ri EY THAT 1 AM PROPERLY ?L"G TE.RED 1N'1 .R INSSCOaNECT PLUG AND -- - '-- - —i�----
Li�E S t .5 QU R_.il BY LOS ANG L i COUNTY AND SIA E Of Ak?ANT.CF HOUSE S�'TER
CALIFORNIA CR FNAT AM THE LEGAL OWNER OF THE ABOVE ._.._
DESCR RJs:-#: P°r'E RTY• BACK FILL SEPIK TANKS 1 '
SIGNATURE
' - SPEP. R IT r _� CESSPOOLS '
OF PERMITTEE -
IOHN A. LAM E. COUNTY ENGINEER t�il�I���sT��N ROBER'7'A. WOOD, C}{fEF RLBG. INSPECTOR
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„C fsr•'x M. 0. CASH -
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