HomeMy Public PortalAbout9650 LIVE OAK AVE_Sewer__ 7.8A88ED AP LOCb"11TMNtl' ®R. TIER 8� Il _
CE808.8 58
COUNTY OF LOS ANGELES SEWER—SEWAGE ®OSPOSAL�
DEPARTMENT OF COUNTY ENGINEER o;
BUILDING AND SAFETY DIVISION' r BUILDING ,
-�C✓.,
JOHN A..L$MBIE, Couatp FmgineADDRESS
or
CASSATT D. GRIFFIN, Sup't of.Building LOCALITY
-. a.. NEAREST..
FOR APPLICANT TO FILL IN -CROSS sT. f�iQf
FS.
EGAL A ,��
RIPTION LOT N0. >6 (7 �'> OWNERKTRACT MAIL
ADDRESS
N0;OF BLDGS:
OF LOT NOW ON LOT' CITY TEL.NO.
USE OF ` r. x
BUILDINGS DISTRICT NO.', GROUP MAP PROCESSED BY
�K PG l _
q CONTRACTOR' isenS
a' ADDRESS CONNECTION DATA `
CITY ;C�FTEL.N0. 6 `_ DEPTH
• `� g -7�J*� �i STATE p
REGISTRATION NO. `T.5 /O / L^"��� HOLE REFERENCE✓
' 7J•` .ed- L WER
No. DESCRIPTION OF WORK. - FEE
HOUSE SEWER CONNECTING TO - - -
PUBLIC SEWER @ $3.00 �d
SEPTIC TANK,SEEPAGE PIT OR TYPE OF CONNECTIONLENGTH FROM
PITS AND/OR DRAINFIELD @ $3.00 Y. CURB P.L. M.L.TO P.L.
OVERFLOW SEEPAGE PIT, DRAIN FIELD-
EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00
HOUSE SEWER CONNECTING TO P.C. N0.
PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP.NO, 7 JOB NO.
CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT N0. ROAD PERMIYNO.
WORK TOHOUSE SEWER @ $1.00 -
- ALTER;REPAIR OR ABANDON.HOUSE STATE ENCROACHMENT' -
SEWER OR DISPOSAL SYSTEM @ $1.00 PERMIT NO.
x
INDUSTRIAL .
`. WASTE APPROVAL -
CHARGES
A
k OWNERS PERMIT $ 2 00 CONNECTION CHARGE FEE
,., AUTHORIZATION TOTAL FEE REIMBURSEMENT IFEIE _
417V4
I 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.PUBLICSEWER. ' f p
SIGNED :THIS Y I9 NEW HOUSE SEWER =1 j I
r OWNER OR ✓L CONNECT ADDITIONAL
OWNERS AGENT BUILDING OR WORK
SEPTICTANK,SEEP,PIT(S)
e-
ADDRESS AND/OR.DRAINFIELD
' I *HEREBY ACKNOWLEDGE THAT 1 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.
A 1 HEREBY CERTIFY THAT I 'A PR RLY GISTE AND R DISCONNECT PLUG AND
LICENSED. AS REQUIRED BY L N L TY A STA OF ABANDON-HOUSE SEWER'
CALIFORNIA AT I AM H G L ER 0 TH BOVE
;i DESCRIBE ESI DE IAL PR E Y' BACKFILL SEPTIC TANKS❑..
SIGNATU E
SEEP.PITS) ❑ .CESSPOOLS'❑
OF PERM TE
OAIJE�TION ROBE T A.WOOD '
M. CAStf SUPERVISING MECHANICAL ENGINEER.
Jc-
. ;,. (/( ..��c,II� ' ���Vp� �^;.J y�-tea p���///��7� .. .
APPU
FOR
CEBOB-8.58 _ �•
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING v
- . . ADDRESS -� sS �• �/� 'a?
JOHN A. LAMBIE, County Engineer
CASSATT D. GRIFFIN, Supt of Building LOCALITY
r j NEAREST §,
FOR APPLICANT TO FILL IN CROSS STLEGAL
�-'�s '
-.DESCRIPTION LOT NO. 44 /�' �-G OWNER �), 6�d, 1
'BLOCK
TRAClt;6;"?0 MAIL
ADDRESS
NO.OF BLDGS. i
SIZE OF LOT NOW ON LOT CITY TEL.N0.
USEOF s off M,
BUILDINGS (s` DISTRICT NO. GROUP MAP a PG PROCESSED BY
CONTRACTOR' O :".S, lr 4,, I 121s
ADDRESS CONNECTION DATA
CITY TEL.NO. r �_o'DEPTH
{ STATE
REGISTRATION N0, i e/ 'M N OLE REFERENCE UP
` NO. DESCRIPTION OF WORK FEE i COWER-)
HOUS
WER-
HOUSE SEWER CONNECTING TO _
PUBLIC SEWER Q $5.00
SEPTIC TANK,SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM a.PI7S AND/OR DRAINFIELD Q $8,00 Y. CURB L. M.L.TO P.L.
lz
OVERFLOW SEEPAGE PIT,DRAINFIELD
i EXTN„CESSPOOL,DRYWELL,MANHOLE Q $2.00
s' HOUSE SEWER CONNECTING TO - P.:C.:NO.
m PRIVATE DISPOSAL SYSTEM - @-$1.00 CO.IMP.NO. �.t -{� f- JOB N0,
CONNECT ADDITIONAL BLDG,OW
WORK TO HOUSE SEWER Q $1_00 TRUNK PERMIT NO. ROAD PERMIT NO. 13 gf 6-D
ALTER, REPAIR OR ABANDON HOUSE STATEENCROACHMENT -
SEWER OR DISPOSAL SYSTEM @'$1.00 PERMIT.NO.
d
L_ INDUSTRIAL
WASTE APPROVAL
• - . CHARGES,
OWNER'S PERMIT $ CONNECTION CHARGE FEE
.AUTHORIZATION TOTAL FEE ®® REIMBURSEMENT FEE ,
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON_ APPROVALS DATEINSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE A OVE DESCRIBED XISTING DWELLING
TO THE PUBLIC SEWER.
SIGNED THIS NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL'
OWNERS AGENT BUILDING OR WORK
SEPTIC TANK,SEEP,PIT(S)
ADDRESS ! AND/OR DRAINFIELD °
1 HEREBY ACKNOWLEDGE 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
I- HEREBY CERTIFY THAT A OPER REGI RED /OR
LICENSED -AS R U[RED - 0 AN EL OUNT AND S. TE OF <`� .DISCONNECT PLUG AND.
CALIFORNI T T I A T E E OWNS OF. TH ABOYE ABANDON HOUSE SEWER:
DESCRIBE RESIDEN A P P T BACKFILL SEPTIC TANKS❑
SEEP IT(S) ❑ CESSPOOL 11
OF
- - _
OF PERMIT
�P AIZDAI'ION• ROBERT A.WOOD.
9. CAStf - (SUPERVISING MECHANICAL ENGINEER
,,fit ry 7 :9, NOV' A 2 5 � :