HomeMy Public PortalAbout6007 MUSCATEL AVE_Sewer__ MD
:6808-8.88 APPLICATION FOR PERMIT 1
808.
COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUMDING AND SAFETY DIVISION BUILDING r _
JOHN A. LAMBIE, County Engineer ADDRESS
CASSATT D. GRIFFIN.Supt of Building LOCALITY
NEAREST
FOR APPLICANT TO FILL INCROSS ST, . ter
LEGAL
DESCRIPTION LOT N0. t a. L OWNER C
✓ Y
BLOCK TRACT 'eMAIL
S ADDRESS
NO.OF BLDGS, -�
SIZE OF LOT NOW ON LOT ®-' CITY TEL.NO.
USE DF
BUILDIVeS _ W 'r � .. -: DISTRICT N0. GROUP MAP PROqrssED BY
BK PG
CONT CT-;a '`✓ _r _ a;"*-
ADDRESS p
CITY
STATION % DEPTH
STATE UP°ER
REGISTRATION N0. ✓� COUNTY MANHOLE REFERENCE,
rIQ. L�ESGRIPTIOK OF WORK-- FEE
HOUSE SEWER CONNECTING TO y 4
PUBLIC SEWER $3.00
SEPTIC TANK',SEEPAGE PIT OR TYPE OFQONNECIION LENGTH FROM 7
Y. CURB. P.L. M,L,TO P.L.
PITS AND,/OR DP.AINf"IELD @ $3.00 �_.. _ _
OVERFLOW SEEPACE PIT,DRAINFIELD
EXTN„CESSPOOL,DRYWELI.,MANHOLE Q MOO
1 HOUSE SEWER CONNECTING TO P.G.N0.
I PRIVATE DISPOSAL_SYSTEM @ $9.00 CO.IMP.NO. 3Y. v JOB NO,
`
CONNECT ADDITIONAL BLDG,OR 1 -i y TRUNK PERMIT NO. - ROAD PERMIT NO. -
WORK TO HOUSE SEWER. $9.00
ALTER,REPAIR OR ABANDON HOUSE STATE ENCROACHMENT
SEWER OR DISPOSAL SYSTEM Q MOO _PERMIT NO,
INDUSTRIAL --
WASTE APPROVAL
CHARGES
AUTHORIZATION
OWNER's PERMIT $ 2. 00 CONNECTION CHARGE FEE
i& � T
UT�IORIT•ATION TOTAL FEE REIMBURSEMENT FEE --- --- ---
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER,
SIGNED THIS--------DAY Oi g_ NEW HOUSE s_wER
OWNER OR `j CONNECT ADDITIONAL
OWNERS AGENT ,d`r BUILDING OR WOR.K
,N
SEPTIC TANK,SEEP, PITS)
ADDRESS _ AND/OR AKIE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL Q DRYWEI_I,❑
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SFWACE DISPOSAL SYSTEM
I F EBY CERTIFY THAT I AM PROPER °"REGISTERED AND/OR DISCONNECT PLUG AND
LIC USED AS REQUIRED BYT qS ANGELE 'COUNTY AND STATE OF
CA IFORN�A OR THAT I A, HE LEG OWNER OF THE ABOVE ABANDON HOUSE SEWER
ANY
/THE
CM134D #ESIDE ,NTI L PPERTY. - - BACKFILL SEPTIC TANKS❑
✓ _ s � SEEP, PIT(S) CESSPOOLS❑
Of ERMI
f
�F
VALIDATION:> ROBERT A.WOOD
¢K. U.0. CAgx_ SUPERVISING MECHANICAL ENGINEER
- L'