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Home My Public Portal About5203 MCCLINTOCK AVE_Sewer__ DEPARThMrr OF COUNTY EN(irNEM SEONER--SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, CouNTY ENtalNtcR BUILDING ADDRES8 FOR APPLICANT TO FILL IN LOCALITY BUILDING '� '� NEAREST ADDRESS J CROSS ST. LOCALITY 14 h " DISTRICT NO. (- RRtdl-1cwAsu� t aSSan PERMIT NO. NEAREST �� — s CROSS ST. RECEIVED BY DATE ISSUED BY DATE OWNER A/l X, L+1 i AA MAIL ADDRESS USE ZONE OCCUPANCY BK MAP PG CITY TEL.8O. CONTRACTOR rr —c .!h6irq;Q SA;.oA&g CO.IMP.NO. ADDRESS i iz Cula rc v,r Ave. JOB NO. CITYEL.NO.1 'i a�ns�l .,T ;t ciiaa� TRUNK PERMIT NO. STATE REGISTRATION NO. ® COUNTY ROAD PERMIT NO, LEGAL STATE ENCROACHMENT DESGR[PT10d LOT NO.; PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO.OF BLOCS. NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE`-,, NO. DESCRIPTION OF WORK FEE — HOUSE SEWER CONNECTING 70 REIMBURSEMENT FEE PUBLIC SEWER CC? $ 3.56 RECEIPT NO. DATE (BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLOCS.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO, I DATE I BY (' SEWER OR DISPOSAL SYSTEM 1.00 '� DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 I CONNECTION bATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DtRTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2,00 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE SIGNED THIS--;--DAY OF_ NEW HOUSE SEWER Pr OWNER ORw, AL OWNERS AGENT ..� ...&�C�.... '�� BUILDING OR WORK ADDRESS.............. -..._ SEPTIC TANK,SEEP.PITS) __.. __.. _ _.---�--- _ .. AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS ADPL" CESSPOOL❑ DRYWELL C CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER.REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND ASID/OR LICENSED AS REQUIRE BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALL OR A O AT, AM THE LEGAL OWN- ER OF THE ABOY IBE E NTIAL PROPERTY. BACKFILL SEPTIC TANKS E] SIGNATURE fir )�1 CESSPOOLS[� OF PERMITTEE. _ _ f 76A642B S&E 663 4/54 f>r ' DEPARTIVIENT OF COUNTY ENGLVEER SEWER-SEWAGE DISPOSAL4623 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES q M WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS G✓ i 'l �f �� FOR APPLIC NT TO FILL..IN LOCALITY d- z!F-/3�P/�, BUILDING NEAREST ADDRESS, CROSS ST. .:Z4 LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST A CROSS ST. o RECEIVED BY Ready for Inspection DATE ISSUED OWNER f', t - �Ir • .yo -'s 'y MAIL USE ZONE OCCUPANCY MAP ADDRESS �- +. BK PG CITY TEL.NO. CONTRACTORS CO.IMP.N0. ADDRESS JOB.N0.`, CITY TEL.NO. TRUNK PE*IT NO. STATE REGISTRATION NG. H COUNTY ROAD PERMITLEGAL DESCRIPTION LOT N0. e , STATE ENCROACHM PERMIT NO. _ BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOTT10,4,SX 11 p NOW ON LOTS• CH^ES USE OF BUILDINGS t_- / CONNECTION CHARGE F NO. DESCRIPTION OF WORK FEE REIMBURSEMENT F HOUSE SEWER CONNECTING TO PUBLICSEWER @ $ 3.50 y ' RECEIPT NO. DATE I BY HOUSE SEWER CONNECTING TO i PRIVATE DISPOSAL SYSTEM 1.08 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORD WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING e'0' DATE + BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER _AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR r PITS AND/OR DRAINFIELD 2.00 STATION ¢ • D DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER UGl'WER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ I 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I '' CONTRACTORHAVE TO CONNECT THATE TE ABOVE DESCRIBED IEXISTING ED APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS.....u-) .DAY OF..-•-- (J !`- -_..I;._. NEW HOUSE SEWER OWNER OR A CONNECT ADDITIONAL OWNERS AGENT -- .. BUILDING OR WORK (( �n ! SEPTIC TANK,SEEP.PIT(S) ADDRESS..'2�-- .._ AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL I] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM t 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 ABOVE DESCR13ED )tESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SIGNATURE �{ f( SEEP.PIT(S)� CESSPOOLS D OF PERMITTEE tom:. ' 76A642A 663 7/53 iJ!