HomeMy Public PortalAbout9944 MILOANN ST_Sewer__ APPLICATION: FOR PERMIT
S B E.o£..32-114
'DIVISION OF BUILDING AND SAM SEWER--SEWAGE DISPOSAL
Dep sat of County Engine
County of Los Angeles BUILDING
1h+;V1.J. FOX.COUNTY ENGINR ADDRESSr
CASS.ATT 0.GRIFFIN,SUPT OF BUILDING LOCALITY �-
_
FOR APPLICANT TO FILL IN NEAREST
LEGAL, _
.DESCRIPTION LOT.fi+O. ,;" t tr ✓ r
BLOCR
TRACT MAIL
- - - - - - -- - -- - ADDRESS
NO.OF ELDGS. -
S'2E NO44,ON LOT _ CITY 'TEL,NO.
U85 OF
BUIL DINGS - D;ST'PtGT NO. GROUP ? kt,0.:P
-7, SK PG
CONTRACTOR
ADDRESS .G,, ' aye; �..,- - _- CONNECTION DATA
CITY TEL. NO. STATION DEPTH
. 0 STATE .- ''�. MANHOLE REFERENCE �-..^.
REGISTRATION NO. El COUNTY UPPER ehwER
TYPE OF CC'ht.NECTION LENGTH FROM }.
NO. AESCRIPTION OF WORK FEE-J _ Y. _ _ CURB P L. NT_L I _P.L.
j HOUSE SEWER-CONNECTING-TO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM, i or, � --_-�----- - - �- -�-- — -�
i
CONNECT A.DDI IONA.L BLDG. OR
WORK TO HOUSE_SEWLR 1.00 � 1 ar>L, CO. IMP. NO. � JOB„�10. .y
ALTER OR REPAIR EXISTING
_ -. MIT_...___._._�_.�
5 T R R REPAIR
SYSTEM t 00 TRUNK PERMIT hO. _ ROAD-PaRi'.A IT NO
D SCONNECT AND ABANDON SEWER
ANI OR DI$PO AL$YSTEM t 00 PERMIT NO.
NATE ENCROACHMENT =�
SEPTIC TANK,SEEPAGE FIT -
PiTS AND OP DRA_ NTiELD _7_ 00 I j� i€dDJ I-PiAL
-- .-- ;);.SIE AGPR0VAL
e CESSPOOL- DRCW EI L
i SPECIAL CON.D O S ONLY _ E 40 ( ._ CHARGES
_ GONt2CCTtfl:N CHARGE FEE,
W'
ONER'S PEST_ _
AUTHORIZATION TOTAL FE � tI�tIRSEMI yr FEE .
_ -
I PAVE THIS n.e'F CONTRACTED WITH THE HEREIN NAMED CON.. c�r
TRACTOR O' CONNECT THE ABOVE DESCRIBED EXISTING DWELLi, ING. APPROVALS � DATE INSPECTOR'S S] NATUR`z.
4V _
TO THE PUBLIC SEER --
SISNFO TIKES_ DAY NEW HOUSE SEWER --
C:WNER OR - CONNECT ADD!i TONAL
OWNERS AGENT _ BUILDING OR WORK
SEPTIC TANK,SEEP, FIT(S)
ADDRESS-__.� '_AND/OR DRAINFIELO
I HEREBY ACKNOWLEDGE THAT 114AVE READ THIS APPLICATION CESSPOOL El DRYWELL
AND STATE 7HAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR SrNZR OR ---
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED .AND/OR DISCONNECT PLUG AND
- - - -- - -
LICENSED AS REQUIRED. BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I ANI THE LEGAL OWNER OF THE ABOVEABANDON HOU5E.S1:V£R _ -- --
DESCRIBED RESIDLNTIAL PROPERTY. BACKFILL SEPTIC TANKS Q
SIGNATURE
OF PERMITTEE - -
WILLIAM J. FOX, COUNTY ENGINEER V'A MATION
BY Y 9 4 7 FEB;2' 4 D
DEPUTY DEPUTE
By BY
11J DI PUTY ✓:....� D*'PUTY
IDEPAWJVMENT OF COUNTY ENGINEER SEVER-SEWAGE DISPOSAL
(VISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES t
WILLIAM J. FOX, COUNTY ENGINEER } BUILDING
ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDINGADDRESS NEAREST
Y'. y- CROSS ST.
LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A S
CROSS ST.
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
MAIL
ADDRESS USE ZONE I OCCUPANCY BK MAP PG
CITY TEL.NO. 6,
I
CONTRACTOR `
CO.IMP.NO.
ADDRESS Olr-4 JOB NO.
CITY TEL.NO. o TRUNK PERMIT N0.
- STATE
REWSTRATI COUNTY ROAD PERMIT NO.
LEGAL V
DESCRIPTION LOT NO. j_z STATE PERMIT ENCROACHMENT
O.
BLOCK TRACT ` INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLOGS.
NOW ON LOT CHARGES
USE OF
BUILDINGS s ,;,���---„e rte_` CONNECTIONIC ARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO .rp REIMBURSEMENT FEE
PUBLIC SEWER 0 $ 3.50 4� G� RECEIPT NO. DATE IBY.
HOUSE SEWER 60NNEBTING TO
PRIVATE DISPOSAL SYSTEM 1.00 .-
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO. I 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
PITS AND/OR DRAINFIELD 2.00 STATION - DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHQ!F PFFERENCE
UPPER
TYPE OF CONNECTION LENGTH FROM
OWNERS _PERMIT I --00
7
Y. CURB �. `�L. M.L.TO P.L.
#
AUTHORIZATION I TOTAL FEE /r✓
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CON ECT THE ABOVE DESC IBED EXISTING
DWELLING TO THE BUC SEWS APPROVALS INSPECTOR'S SIGNATURE DATE
SIGNED THIS _-DAY OF, _..: .......I NEW HOUSE SEWER
OWNER ORCONNECT ADDITIONAL
OWNERS AGENT �J �a�sa.:...- :4�pe :-.._.... BUILDING OR WORK
ADDRESS . --�►� �}{ .L_ SEPTIC TANK,SEEP.PIT(S)
/ r p _AND/OR DRAINFIELD
1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL 0 DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
RECULATiNG PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFO I OR THAT A AM E LEGAL OWN-
ER OF THE A ` III D RI NTI PROPERT KFILL SEPTIC TANKS t:]SIGNATURE
P.PIT(S)[:] CESSPOOLS[]
OF PERMITTEE... w. _
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