Loading...
HomeMy Public PortalAbout9544 LIVE OAK AVE_Sewer__ CE608.8C6�08.8.88 APPLICATION; FOR "PERMIT -7 ' COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL 1 DEPARTMENT OF COUNTY ENGINEER BUMDING AND SAFETY DMSION BUILDING > JOHN A. f AMBLE, County Engineer ADDRESS - CASSATT D. GRIFFIN, Sup't of Building LOCALITY 7x;c- NEAREST FOR APPLICANT TO FILL IN CROSS ST.'LEGALOWNERDESCRIPTION LOT N0.BLOCK' TRACT MAIL `r U) /ADDRESS /D /sy NO.OF BLDGS.SIZE OF LOT /S D NOW ON LOT © CITY L. USE OF BUILDINGS 11,�S DISTRICT.NO. GROUP MAP PROCESSED BY CONTRACTOR „ PG ADDRESS CONNECTIO DATA CITY DEPTH STATE A HOLER FE NCE r• REGISTRATION NO. - COUNTY ) D I _ R No. DESCRIPTION OF WORK FEE - HOUSE SEWER CONNECTING TO - PUBLIC SEWER $3.00 SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM Y CURB P.L. M.L.T P.L. PITS AND/OR DRAINFIELD � $3.00 OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN ,CESSPOOL,DRYWELL,MANHOLE $2.00 HOUSE SEWER CONNECTING TO P.C. NO. .N PRIVATE DISPOSAL SYSTEM @ $1.00 CO IMPO. JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. WORK TO HOUSE SEWER @ $1.00 ALTER, REPAIR OR ABANDON HOUSE STATE ENCRO MENT SEWER OR DISPOSAL SYSTEM @ $1.00 PERMIT NO. INDUSTRIAL //'�� WASTE APPROVAL 0. CHARG OWNERS PERM g CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE -J jogL! -REIMBURSEMENT FEE e'� 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. SIGNED THIS DAY OF -194-:5 NEW HOUSE SEWER OWNER OR �— CONNECT ADDITIONAL OWNERS AGEt UhlBUILDING OR WORK SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD AD HEREBY ACKNOWLEDGE THAT 1 HAVE RE THIS APPLICATION STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS ❑ SEEP.PIT(S) CESSPOOLS❑ SIGNATURE OF PERMITTE *7196 . OF ALIDATION ROBERT A.WOOD CASH SUPERVISING MECHANICAL ENGINEER LACO 3 2, 1 5 s SEP 2 8 1 1 A 2-5.00 �. • Jam° � , T �)6,A842D BeAPPLICATION., FOR PERMIT • `cede a- COUNTY OF LOS ANGELES SEWER-7—SEWAGE DISPOSAL ' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDINGADDRESS, ADDRESS' IOHN A. LAMBIE, County Engineer, . CASSAIT D. GRIFFIN, Supt of Building LOCALITY ' T -`, NEAREST /J/ - ' FOR APPLICANT TO FILL IN CROSS ST. %4 LEGAL DESCRIPTION LOT NO. OWNER BLOCK, TRACT t S s. .f4t✓ MAIL ADDRESS NO.OF BLDGS. • - SIZE OF LOT (� MOW ON LOT CITY TEL NO USE OF —BU L"" UILDINGS DISTRICT . GROUP �St MAP PG PROCESSED BY { ' CONTRACTOR `1 �j �� ADDRESS CONNECTION DATA CITY 1 � � TEL.NO. L1 (,(p b r a, DEPTH [ TATE N OLE REF RENCE REGISTRATION N0. LJ COUNTY 'Zp ER" NO. DESCRIPTION 0 WORK FEE \. , PUBLIC SE WE RCONNECTING TO $3 .00 ' .A ` SEPTIC TANK, SEEPAGE PIT ORTYPE OF CONNECTION .. LENGTH FROM r PITS AND/OR DRAINFIELD _ •@ $3.00 CURB- P. M.L. TOP L. OVERFLOW SEEPAGE-PIT, DRAINFIELD - EXTN.,CESSPOOL,DRYWELL,MAN HOLE @ $2.00 HOUSE SEWER CONNECTING TOP.C.'N0. PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. N0. JOB NO. ' WORK TO HOUSE BLDG.OR @ $1.00 TRUNK PERMIT NO. ROAD PERMIT N0. SEWER OR DISPOSAL SYSTEM HOUSE @ $1 00 STATE ENCROACHMENT_ PERMIT N0. _ INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PEW= $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE 7 ✓ REIMBURSEMENT FEE {. , I HAVE AT THIS-DATE A CONTRACT WITH THE HEREIN NAMED CON. TRAPPROVALS : DATE INSPECTOR'S TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING R'S SIGNAT URE / R' TO THE PUBLIC SEWER. NEW HOUSE SEWER OWNER OR �S/ JIE1i/9--�fiY SIGNED THIS ' AY OF19107CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK' SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR.DRAINFIELD I HEREBY NOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT'THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑' DRYWELL❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE'DISPOSAL SYSTEM ' IICHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE-SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC,TANKS❑ SEEP. PIT(S) ❑ CESSPOOLS SIGNATURE - e OF PERMITTEE ®r = AMATION ROBERT A.WOOD CB. Y.u. CA$H SUPERVISING MECHANICAL ENGINEER --.�. 3.2 1-4,$ SU-228 1 O' A 5.00 .'