HomeMy Public PortalAbout9556 LIVE OAK AVE_Sewer__ DEPARTAIENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF 'BUILDING AND SAFETY PERMIT APPLICATION
COUNTY-OF LOS ANGELES' a '
WILLIAM J. FOX, COUNTY ENGINEER BUILDING'F ��� �1 CASSATT D. GRIFFIN, SUPT OF BUILDING ADDRESS Lf lel �0 Old I/®
FOR APPLICANT TO FILL IN 1 LOCALITY e y71 , A /►
I
BUILDING ADDRESS CROSS ST.
LOCALITY oD f
DISTRICT NO. SERIA,QNO.. PERMIT N0. Or
c
NEAREST c� A
CROSS ST. .-
OWNER RECCA EpJ3Y Ready for Inspection �AT 1-&3
MAIL j �,/(,//K •e('�S lJ
ADDRESS f USE ZONE OCCUPANCY MAP
BK PG
CITY TEL.NO.
CONTRACTOR? //��� CHAR ES ,11 REIMBURSEMENT FEE
ADDRESS�D x / T, REQUIRED
CITY F TEL.NO.4,,XIj jj p NOT REQUIRED
j� JOB.N0. CONNECTION CHARGE FEE
REGISTRATI NO. v COJIASTATE
N CO.IMP.NO. —
LEGAL RECEIPT NO. I DATE BY
DESCRIPTION LOT N0. ��.�- —'
'BLOCK; TRACT
�ilio�l•.u+^ ..L�r.J g-�C.iLdo ' WAIVER FOR RECORDING
SIZE OF LO a �v/ G N0.OF BLDGB.L �
(/, YM of �� NOW ON LOT .r.� RECEIPT N0. -BY
USE
USE
BUILDINGSLe:t� TRUNK PERMIT NO. r• - "'""' "
NO. DESCRIPTION OF W%3RK FEE _
'_HOUSE SEWER,CONNECTINO TO •ROAD''PERMIT N0. "
PUBLICSEWER' li, Q $-,3.50 0
HOUSE SEWER CONNECTING TO STATE ENCROACHMENT '
PRIVATE DISPOSAL SYSTEM 1.00 PERMIT NO.
CONNECT ADDITIONAL BLDG.-OR INDUSTRIAL
WORK TO HOUSE SEWER 1.00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM- 1 00 CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 001
SEPTIC TANK,SEEPAGE;PIT OR STATION 2 -7- vF'� DEPTH 7
PITS AND/ORDRAINFIELD _MANHOLE REFERENCE ' / /��'
CESSPOOL—DRYWELL 'NPP-EER---- OWER
SPECIAL CONDITIONS ONLY 2.00 I _ I TYPE OF CONNECTION LENGTH-FROM f _
CURB 4-.::rr ML.TO P L.`-
OWNERS PERMIT $ . 1 00
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREiN NAMED
CONTRACTOR TO'CONNECT THE ABOVE DESCRIBED EXISTING- ''APPROVALS ` fNSPECTOR'SSIGNATURE DATE
DWELLING TO THE PUBLIC SEWER \ h
SIGNED THIS_-_.-..._.. .. .D Y O � ,
-------•_--------�-------------. 19�-- ) NEW HOUSE SEWER ��� f vi,�i.s. ,• -
OWNER OR /� '�� CONNECT ADDITIONAL
OWNERS AGENT .... ... J.:C�`� BUILDING OR WORK
- - t - -
ADDRESS ' S SEPTIC TANK,SEEP.PIT(S) -
--- ---------- AND/OR DRAINFIELD
IHEREBY AC OWLEDGE THAT I HAVE READ THIS AAPLI. CESSPOOL f j DRYWELL E] l �� f
CATION AND ST E THAT THE ABOVE IS CORRECT AND AGREE •5 h/�
�liGff
TO COMPLY WITH ALL COUNTY ORDINANCES,AND STATE LAWS ALTER,REPAIR SEWER
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 ABO DESCRI RESIDE TIAL PROPERTY. BACKFILL SEPTIC TANKS
SEEP.PIT(S)[-] CESSPOOLS
SIGNATURE
OF PERMITTE -- - its
ro
76A6421) 663 12/52 - -
' ' r
DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS-ANGELES `
y WILLIAM J. FOX, COUNTY ENGINEER ADDRESS ,x"3'8
CASSATT D. GRIFFIN SUP;r DF BUILDING
FOR APPL CANT TO FILL IN LOCALITY 70Pm oa
BUILDING NEAREST
ADDRESS CROSS ST.
LOCALITY DISTRICT NO. SE IAL NO.
PERMIT N0. c
NEAREST A (y}p ��4,0 J
CROSS ST
REC VED B Ready for Inspection DATE ISSUED
OWNER
MAIL
ADDRESS (,p USE ZONE OCCUPANCY MAP
BK PG
CITYT�L.NO. ���
CONTRACTOR CHARG S REIMBURSEMENT FEE
- s
ADDRESS REQUIRED
1
NOT REQUIRED
CITY TEL.NO
JOB.N0. � CON NEC •ON C AFiGE.F_EE
REGISTRATI N NO. STATE
[p Q COU T CO.IMP.NO. I c`
LEGALRECEIPT N0. DAT_E BY
DESCRIPTION LOT N0. �"`I��f
BLOCK TRACT WAIVER FOR RECORDING
SIZE OF LOT �i NOW ON LOT NO.OF BLDGS.
USE RECEIPT..N—N0I T
. DAE °8Y`
BUILDINGS
6 Y DC1 I
NGS pL/
NO. DESCRIPTION OF W RK FEE NO. PERMIT N0.
HOUSE SEWER CONNECTING TO ROAD PERMIT NO.
PUBLICSEWER @ $ 3.50
HOUSE SEWER CONNECTING TO STATE ENCROACHMENT ~
PRIVATE DISPOSAL SYSTEM t.00 PERMIT NO. i
CONNECT ADDITIONAL BLDG.OR INDUSTRIAL
WORK TO HOUSE SEWER 1.00 Q WASTE APPROVAL
ALTER OR REPAIR EXISTING r
SEWER OR DISPOSAL SYSTEM r 1 00 CONNECTION DATA N
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 1.00 STATION DEPTH
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD - 2.00 MANHOLE REFERENCE
CESSPOOL—DRYWELL I I UPPER LOWER
SPECIAL CONDITIONS ONLY 200 TYPE OF CONNECTION, LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERS PERMIT $ I 00
AUTHORIZATION TOTAL FEE
bD
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER ��////
SIGNED THIS._= A.__li4-1�
I ----- NEW HOUSE SEWER
- --------------------------
OWNER. OR CONNECT ADDITIONAL
/sem
OWNERS AGENT - Rf/ /----- •-Y--- _ BUILDING OR WORK
ADDRESS.-............ - � SEPTIC TANK,SEEP.PIT(S)
- _- - -------•------ AND/OR DRAINFIELD
I HEREBY ACK OWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL(�DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I 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 DESCRIBED R [DENTIAL PROPERTY. BACKFILL SEPTIC TANKS Ej
i I SEEP.PIT(S)E] CESSPOOLS❑
SIGNATURE � "
OF PERMITTE - .....I......
76A642D 663 12/52