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HomeMy Public PortalAbout9454 LONGDEN AVE_Sewer__ APPLICATION FOR PERMIT COUNTY OF LOS ANGELES t..� DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL, BUILDING AND SAFETY DIVISIO'IV u tLD! JOHN A. LAMBIEr County Engineer ADORES,' _P f� —----- WILLIAM A. IENSEN, Supt of Building o _ LOCALITY FOR APPLICANT TO FILL IN C ROSSST _- -- - ------ - - r DcSCRIPT!6NLOT N 0. OVVNFR � , ' Ssf .k1 . f:/'c MAIL ' BLOCK �.'t TRACT ADDRESS �i,m,-. NO OF BLDGS, f - J'+ 9� Jj F C'TY TEL NO .9a. . � i SIZE OF L01. 3. e �__§aC ,'.'+ NJW ON SOT U�=E OF BUILDINGSI YP"y" ., „`r ,'1"`""�'`•� D _ :STR!CT NO. 611.9 -P MAP PROCESSED BY r J CONTR CTOR ,'z Aid " ADDRESS CONNECTION DATA q J s� Ai/'rY 9'•- STATION _, ✓ x .t` '- OL'PT b; L.F, '�.. - C!TY x } ✓ .�,%,e�I TEL. R>=•G iSTFCATI dPa *:O. i63 ,� ✓ Y • t _ '..._;k's},.�.. STAT _A_.HCt..E'REFERENCE , 1 7' �' UPPER a NO. UESCRIr"TiC7N °J F' `NORK FEE -- YYFF OF CONNECTION ---- LENGTH FRO —�-- -._ _—- -_. ... .___ — — y' HOUSE S r ER CONNECT—[NO-70--- $ -OQ E Y -^_CURB __ P L— ._ M.L.TO P L. ' PU-'a S W R @ - P L NO 9 SC 7! D,'O SEEPAGE P.7 GRCO !MP.NO. j ^i� f� ✓�._ _- JOB NO.. F T RN AOR DRAT vF1ELD 0.00 J HCUbE'SEN! R TONNE �:NG TO PR to-I,E D TRUNK PERMIT NO ROAD PERMIT NO. ✓ < 05AL SYSTEM. w3-00 d�� " '--2 1 LO T -'OUSE EiLDG ..R AF�'iDAMY utiA vER EASEJExi --REL ORO. !NSTR. Nc7-_ --) DA7E 9 WORK TO HOUSE SEWER $.3.00 I / , OVERFLOW SEFPAGE YET,DRA NFIELD EATf:.,CtSSPOOI__,CRYW ELL MANHOL '—M' $5.00 - __._. —__—. F______. HWY.OR ST.WI LIEN I NG ALTZR-,REPAIR OR ABANDON HOUSE; .-.;'.V ER OFi U!5F05AL SYST"M L $3.00 I SfATE ENCROALH'M EPdY nER.M T NO. r INDUSTRIAL WAST'£APPROVAL - " II PERMIT 2I 00 i k l cFZ-,qGS v-,- ✓ CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE i HAVE AT THIS DATE A CONTRACT WITH THE; HF.RE)NNASAED CON. RE_MHURSE;MECT FFE TRACTOR TO ON NECT THE ABOVE DESCRIBED EXiSTiNG DWELLfNG _,.r TO THE PUBLIC SFVs ��t. y" ,, *y y�pp����ppp,y�-g,S DATE INSP>=CTOR'b SIGNATURE SIGNED THIS AY O .-�r`—� ---t s�,:� --- 'OWNER OF -q NEW HOUSE SEWF_R .. OWNERS AG E'1F _ y `�-- CONNECT ADDITIONAL ADDRESS '1"' �'" '3• BUILDINGOft'NORM -_ SEPTIC TANK,SEEP,Pi T:(:S) I HEREBY' ACKNOWLEDGE THAT I HAVE READ THIS APPL7.•ATION ANL.;'OR DRAINFIELO AND S A1c. THAT THE ABOVE I CORRF T AND AGREE TO "COMPLY i WITH ALL COUNTY ORDINANCE AND STA,'TE LAWS R[GULATING r- P.,L;MBING. AND SEWERS. CESSPOOL 2 DRYWELL � I r HF_RF.BY CERTIFY THAT Y AM PROPERLY REGI STE.R£D AND/OR ALTEEi,Ri PAIR,SEWER O:€c I { • E L s CO AOF, RE INTEND OF RI5 ABANDON HOUSE SEWERS EM �_.—_._--.. _.—_..— ------ RESIDE .__ _ RESIDE tN,. 7H pEt �ESRYH D RE D ENTI BA_Kf ILS.§EI-..t: .Afv?(� RE N E IN. OR T.fA AM 7HE LEGA OWNER OF, AND INTEND 7'O S t _ f -- — —_-�-- Li S REQUIRED 9Y LCS ANGLES I � I OF PERMIT Y£E _ a}' �Ck _ -a t'�Y,L- LJ SEE-P.PIYfS.)' 1.' CESSPOO LS VALIDATION -__ ROBERT A. MOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH - �e