HomeMy Public PortalAbout5240 MCCLINTOCK AVE_Sewer__ nEr�s rr OF COUNW MGM= SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUMDING AND SAFETY PERMIT APPLICATION
COUMM OF LOS "GMM
• 'LIAM J. FOX, CO N.TY ENDIIN6ER BUILDING
}•J✓Ci+, ADDRESS `f p� �® lJfcCA—
FOR APPL NT TO IN LOCALITY
ADDREBUILDSS�A V C2 CCj:L,/rtl rV C& 4_&_lr',' NEAREST - �
CROSS ST. _ . -51 r
LOCALITYT�ryj ��,�. G �-y' DISTRICT N0. Ready for Inopeotion PERMIT N0.
NEAREST �- G C' ..5'_ 377' 93 S
CROSS ST. /r/?AE Ar .J ;,
_ RECEIVED BY DAT�Er ISSUED BY DATE
OWNER �^i�/ /�/� i G'%�/♦�CG�- r zr_o j ��i //� A�.di�,./ //MAIL
ADDRESS ,�J°�/�LUSE ZONE OCCUPANCY BK MAP PB
CITYS,
CONTRACTOR
CO.IMP.Ne at 1490.
ADDRESS `j �a r r
f -� JOB N0.
CITY N TRUNK PERMIT NO.
STATE
REGISTRATION WCJ .�+ ® COUNTY ROAD PERMIT NO.
DESCRIPTION LOT NO.LEGALW- .9 STATE ENCROACNM
PERMIT NO.
BLOCK TRACTj G'y Jv G INDUSTRIAL -
WASTE APPROVAL
SIZE OF LOT gS 411NO.X C!y r NOW ON LOTS CHARGES
USE OF -
BUILDINGS I( CS l CONNE ON CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEM&TqE
PUBLIC SEWER M S 3.60 ���. RECEIPT NO. I D I BY
HOUSE SEWER CONNECTING TO
_ PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.08 CEPTION RECO O
_ WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- I DATE
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
_ PITS AND/OR GRAINFIELD 2.00
DEPTH
CESSPOOL—DRYWELL STATION ' 19y
SPECIAL CONDITIONS ONLY 2.00A�s RIA HyBEFERENCE
Amer
I TYPE OF CONNECTI aENOTH FROM
OWNERS PERMIT ; 1 00 Y. CURB P.L. Gr M.L TO P.L.
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PU13LIC SEWER
SIGNED THIS�� DAY OF v✓' 1� NEW HOUSE SEWER
OWNER OR ' CONNECT ADDITIONAL
OWNERS AGE T BUILDING OR WORK
ADDRESS`—r Z61—L9. .L 0c !r' SEPTIC TANK,SEEP.PIT(S) i
� 7 -y AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THATPA-AVE READ THIS APPT CESSPOOL[] DRYWELL 0
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
STEREO
AND%OR LICENSED EREBY IAS REQUIFY THAT RED BY BY LOS ANGELES COUNTY
N DISCONNECT PLUG AND
A D STATE OF CALIFORNIA OR THAT 1 A4-THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RES�TIAL PROPERTY. BACKFILLSEPTIC TANKS
� /
SIGNATURE SEEP.PIT(S)[] CESSPOOLS
OF PERMITTEE L
TOA642D S&E 663 4/64