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Home My Public Portal About5947 MUSCATEL AVE_Sewer__ 76A 75AJ 420 E2-613 APPLICATION FOR PERMIT �� `' �v COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSA DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS er COLEMAN W. JENKINS, SUPT, OF BUILDING �/c c LOCALITY NEAREST FOR APPLICANT TO FILL IN CRo53 sr. cu—cl LEGAL _.. E- DESCRIPTION LOT NO. OWNER P MAIL BLOCK TRACT �'— ', ' ADDRESS NO. OF BLDG$, SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF BUILDING5 DISTRICT NO. GROUP MAP PROCESSED BY SK PG CONTRACTOR ADDRESS (�. �: CONNECTION DATA CITY '' ...y_ TEL. NSTATION DEPTH STATE LIC 29 yrr� /F,(.w�� MANHL,E REFERENCE UPPER LICENSE NO.- CLASS 4r^'7 ( LOWER NO, DESCRIPTIOWOIF WORK FEE TYPE 0-KCONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. RB P.L. M.L.TO P.L. PUBLIC SEWER $5.00 SEPTIC YANK,SEEPAGE PIT OR P.C.NO. PITS AND/OR DRAIN FIELD $10.00 CO. IMP. NO. ` JOB NO. HOUSE SEWER CONNECTING TOTRUNK PERMIT NO. �"- ROAD PERMIT NO. >- PRIVATE DISPOSAL SYSTEM @ $3.00 .. a CONNECT AUDITIONALBLDG OR AFFIDAVIT w.{�fY[E�[ASEM EN T- REC D.INSTR NO. DATE WORK TO HOUSESEWER @ S3.00 I ' OVERFLOW SEEPAGE PIT DRAINFIELD _� __ � Q _j EXTN CESSPOOL.DRYWELL.MANHOLE @_55.00 ! _ HWY.OR ST.WIDENING ALTER REPA+R'fl7t'ABANDON HOUSE �L, t.) SEW ER_OR G>I& 9'P6iEM �.s+' .___._ _.__—.— ___. $3_00 L_ - STATE ENCROACHMENT C1. ! 'PERMIT NO. -------" INDUSTRIAL WASTE APPROVAL - OWNERS PERMIT— --S z 00 --- _CHARGES — CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TQ CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWERQ �t��f➢ APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS S AY OF—I I _Ig ------- ------ OWNER OR /—,�� 74 NEW HOUSE SEWER OWNERS AGENT_,�,i + CONNECT ADDITIONAL ADDRESS-- BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS+APPLICATION SEPTIC TANK_SEEP,PIT(S) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOCOMPLY 'AND/OR DRAINFIELD WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I 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 CALIFORNIA OR THAT i AM THE LEGAL OWNER OF, AND INTEND TO p15C ONNECT PLUG AND RESIDE IN. THE AB - RES �- -- SEEP.PIT(S) ❑ CESSPOOLS VALIDATION JACK R. ALLEN CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER S At'1 .4 0 0 4 .. $.') J 5.CJ�,e) :EBUB 12-Ba` >6A 6420 APPLICATION FOR PERM COUNTY OF LOS ANGELES SEWER—SEWAGE DISP4SAL. � DEPARTMENT OF COUNTY ENGINEER. BUILDING AND SAFETY DIVISION BUILDING - JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING, t LOCALITY / NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT'NO. OWNER - 6 MAIL - BLOCK TRACT ADDRESS NO. OF BLDGS, / T' SIZE OF LOT NOW ON LOT CITY ' -� TEL, NO. USE OF BUILDINGS DISTRICT NO. GROUP MAP sFjtOCESSED BY SK PC CONTRACTOR �.-� F` /'� '.7 L.:;_.. y.1:<>�•ry,i�,. ' ADDRESS v CONNECTION DATA /(d STATION y4. DEPTH CITY - TEL. NO. STAYS LIC MANHOLE REFERENCES Y FPERd LICEI4SE NO, CLASS„ LOWER NO. DESCRIPTION OF WORK FEE TYPE OF GTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. p.L. M.L.TO P.L. PUBLIC SEWER $5.00 8 P.C.NO. SEPTIC AND/OR YANK. RAINFIf PIT OR CO:IMP.NO. 7 JOB NO. PITS 0.NDi OR ORAINFIELO � $10.00 I _..` __JOB RtVA SEWER CON SYSTtNG TO- -- -�� v TRUNK PERMIT NO. _ -T ROAD PERMIT NO. - r PRIMATE DISPOSAL.SYSTEM @ $9.00 i5-7 d CONNECT ADDITIONAL BLDG OR +- i AFFIDAVIT wAIY[R [ASSN EMTT RECORD.INSTR.N0. DATE WORK TO HOUSE SEWER @ $3..00 OVERFLOW SEEPAGE PET.GRAINFIELD _-._ EXTER.REPAIR R RYW DON HNHOLE $5,00 HWY OR ST.WIDENING ALTER REPAIR OR ABANDON HOU5E (� i SEWER OR DISPOSAL SYSTEM � $3_00 - STATE ENCRbACH MENT L' ..—_— PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT---- -- s' _ '100 ---- ---- ---- — --- -� - CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE I I HAVE AT THIS DATE A CONTRACT WIBE TH THE HEREIN NAMED CON- REIMBURSEMENT FE TRACTOR TO-CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -- -- ------ TO THE PUBLIC SEWER. DATE, I PECTOR' I ATURE SIGNED THIS .DAY'OF 19_, ----APPROVALS_ OWNER OR NEW HOUSE SEWER CV CI � '✓�_ OWNERS AGENT- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS--_ _ SEPTIC TANK,SEEP,PITS) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY -----_._. WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING Q PLUMBING AND SEWERS. CESSPOOL ❑ DRYW ELL IHEREBY CERTIFY THAT I AM_t PROPERLY REGISTERED AND/OR ALTER.REPAIR,SEWER OR LICENSED AS REOUiRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO DISCO NN ECT PLUG AND RESIDE IN, TMEABOVE DE:SCRIBEO� RESID£NT:'AL PROPERTY. -�T ABANDON HOUSE SEWER 1 SIGNATURE' BACKFILL SEPTIC TANKS ❑ OF PERMiTT,EE ___ ____ _ '_�:�___.-.__ SEEP.PITIS) Q CESSPOOLS ❑ VALMATIO�yE�+�CASH JACK R. ALLEN CK. M.Oy / SUPERVISING MECHANICAL ENGINEER . _