HomeMy Public PortalAbout6146 MUSCATEL AVE_Sewer__ '4Ag4.8.I� APPLICATION FOR PERMIT 1
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COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVI5ION I QZLDING
JOHN A, IAMBIE« County Engineer
CASSAT3 D. L;ILIFFIN, $np«t of Building LOCALITY_
-.
NFAREST
FOR APPLICANT TO FILM. IN CROSS sT.
LEGAL --'
DESCRIPTION I.OT NO,21
A
BLOCK TRACT to �� V trSAIL
NO.OF BLDGS.
SIZE OF LOT�� NOW ON LOT CITY TEL. N0.
USE OF
BUILDINGS s � v*`e DISTRICT NO. GROUP MAP I PROCESSED BY
...�_. BK PG
CONTRACTOR
ADDRESS � � CONNECTION DATA '
CITY : TEL.NO. H + STATIONDEPTH `
STATE MANHOLE REFERENCE'
REGISTRATION NO. `COUNTY 'COINER
NO. DESCRIPTIONOFWORK FEE _
OUSE SEWER CONNECTING TO
_ PUBLIC SEWER
SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM
PITS.AND/OR DRAINFIELD @ $9.00 Y.
.-CURB P.L. I1.L.TO P.L.
OVERFLOW SEEPAGE PIT, DRAINFIELD
EXTN.,CESSPOOi DRYWELL,MANHOLE 0 $2.00
HOUSE SEWER CONNECTING TO - P.C.N0,
_PRIVATE DISPOSAL SYSTEM_ @ $1.00 CO.IMP.NO. JOB NO.
CONNECT ADDITIONAL.BLDG.OR. _ _TRUNK PERMIT NO. ROAD PERMIT NO. _--
WORK TO HOUSE SEWER__ @ $1.00
ALTER,, REPAIR OR ABANDON HOUSE 4STATE ENCROACHMENT
SEWER OR DISPOSAL SYSTEM @ $1.00 PERMIT N0.
JINDUSTRIAL --�.�.---
- WASTE APPROVAL
CHARGES
OWXEjS PERMIT 2 CO CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR. TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC.SEWER. v
SIGNED THIS DIAY OF—-----19__________19� NEW HOUSE SEWER
OWNER OR >` .`� "-. I". , �CONNECT.ADDITIONAL
OWNERS AGENT '
BUILDiNGORWORK
' SEPTIC TANK,SEEP, PIT(S)
ADDRESS AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION- —
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL Il DRYWELL 0
WITH ALL COUNTY ORDINANCE',S AND STATE LAWS REGULATING FALTER,REPAIR,SEWER OR ^V
PLUMBING AND SEWERS, _SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AFS PROPERLY REGISTERED AND/OR JiSCONNEC'T PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEG$L1WNER OF THE ABOVE — --
DESCRIBED RESIDENTIA4 PROPERTY,, � ! BACKFILL SEPT€L TANKS,E-]
SIGNATURE ST'' RTCESSPOOLS
.'')"
OF PERMITTEE
'VALIDATION ROBERT A.WOOD
CK. _I x,c, CASH SUPERVISING MECHANICAL ENGINEER