The URL can be used to link to this page

Home My Public Portal About10432 MILOANN ST_Sewer__ DI:PARTMI ENT OF COUNTY ENGINEER SEWER--SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES � WILLIAM J. FOX, COUNTY ENGINEER BUILDING !A ADDRESS "?j 2,- FOR APPLICANT TO FILL IN LOCALITY BUILDING NEAREST 14 ADDRESS 6 w _ GROSS ST. /- LOCALITY — DISTRICT NO. SERIAL N0. 5�,PERMIT NO. r NEAREST CROSS ST. -- RECEIVED BY ady for Inspection DATE ISSUED OWNER r m. t.1. .—. �_..—_ a• y MAIL > C_ _ — _ USE ZONE OCCUPANCY BK MAP ADDRESS PG CITY 'r TEL..NO. I, CONTRACTOR Co.FMP+N0. ADORESB.�6 m f — JOB.NO. CITY . :6+',z TEL.NO. TRUNK PERMIT NO. STATE REGISTRATION NO. +; �, ❑ COUNTY ROAD PERMIT N0. LEGAL STATE ENCROACHMENT DESCRIPTION LOT N0. PERMIT NO. BLOCK TRACT INDUSTRIAL -- WASTE APPROVAL SIZE OF LOT NO.OF BLDG& CHARGES NOW ON LOT USE OFIt BUILDINGSr-Y---4-' CONNECTION CHARGE FEE NO. I DESCPiPT1ON OF W13RK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER @ $ 3.50 RECEIPT NO. DATE IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR 1 �' TY " EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 f C/ NO. ALTER OR REPAIR EXISTING 1 DATE BY SEWER OR DISPOSAL SYSTEM 1.00 1 DISCONNECT AND ABANDON SEWER __AND/OR DISPOSAL SYSTEM 1.00 I CONNECTIOt4 DATA _ SEPTIC TANK,SEEPAGE PIT OR PIT_S_AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ I 1 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION ! TOTAL FEE CONTRACTORHAVE TO CONNECT DATE THEED TOABOVE DESCRIBED IEXISTING ED APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER +e — SIGNED THIS...,?,. OF___..-_-----__.-_._._._ . ..19_: , NEW HOUSE SEWER_ OWNER OR CONNECT ADDITIONAL i OWNERS AGENT BUILDING OR WORK ' a - SEPTIC TANK,SEEP.PIT(S) ADDRESS-¢...:d..._�._ .. `_------ - ........................ AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE 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 OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM ! HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER I AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBEDRESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS 0 SEEP.PIT(S)E] CESSPOOLS E] SIGNATURE OF PERMITTEE.-_ Y �• •t F-`. _.. i= , 76A642A 663 7/53 6A 642D_CY808 -tt!!0.71 APPLI CATI OIW-'FOR IPERM IT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING I ) ADDRESS / © ',_ JP Cl/ LOCALITY NEA FOR APPLICANT TO FILL IN CROSSSST. YYr i LEGAL DESCRIPTION LOT NO. OWNER �• c MAIL BLOCK _ TRACT [f "' ADDRESS e NO. OF BLDGS. ,g SIZE OF LOT NOW ON LOT F �^� _ CITY TEL. NO. 4 Ll s Ii USE OFMAP ES,SED BY BUILDINGS DISTRICT N0. 1 .ylaR'B4, BK CONTRACTOR G-= ADDRESS ( � , _ CONNECTION DATA CITY P� t TEL. N0.� - cy- a.,5 STA -ION DEPTH a UPPER STATE oy 1C b. MA HOLE REFERENCE LICENSE NO. �',,. ' _ CLASS LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER $$7.00 P.C.NO. SEPTIC DANK,SEEPAGE PIT Oft CO.IMP. NO. PITS AND/OR DRAINFIELD $10.00 7 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT N CL PRIVATE DISPOSAL SYSTEM $3.00 O r_ _ -AFFIDAVIT. _ - CONNECT ADDITIONAL BLDG.OR WAiYEA EASEMENT RECO-RD.INSTR NO. ATE V WORK TO HOUSE SEWER $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD _ ad - EXTN..CESSPOOL.DRYWELL. a $•5.00 HWY.OR ST.WIDENING F ALTER,REPAIR OMl�IIY®CN HOUSE __ V I/ SEWER OR 94OlOSRt SYSTEM _x_$3_00 _ STATE ENCROACHMENT )JJ MANHOLE ---- $7.00 PERMIT NO. D. -- -------- -- - - INDUSTRIAL H �� + WASTE APPROVAL OWNER'S PERMIT ffi 3 00 -- CHARGES AUTHORIZATION TOTAL FEE P CONNECTION CHARGE FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON, REIMBURSEMENT FEE TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER_ APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF---19— OWNER F _ 19_OWNER OR NEW HOUSE SEWER OWNERS AGENT -- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS �- '- SEPTIC TANK.SEEP,PIT(S) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLU MB!NG AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM 6' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIWSIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE � 'OF PERMTTTEE_. � " - ^'` _+�«-g,._±'� BACKFILL SEPTIC TANKS ❑ SEEP.PITIS) ❑ CESSPOOLS ❑ . '. VALIDATION CK. M.O. "CASH J. 0 7 atr 1 U 6.jO A,w,'