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Home My Public Portal About6238 MUSCATEL AVE_Sewer__ �E808 16A 642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL 11 aai DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS r COLEMAN W. JENKINS, SUPT. OF BUILDING 0 L IT, LOCALITY BUILDING R 0 7 FOR APPLICANT TO FILL IN rS S! CROSS-ST. (PRINT OR TYPE ONLY) -- -- -'-EGAL-- OWNER LOT NO. BLOCK TRACT MAIL ADDRESS —— --------- SWO. OF BLDGS, y. SIZE OF LOT NOW ON LOT CITY TEL- NO. -USE OF BUILDINGS DISTRICT NO.J.GROUP CLASS MAP PRPCESSEu BY 13K PG GONTRACTORII!- :�-ri ADDRESS CONNECTION DATA ON DEPTH Y)F- ICY, STATION NO. 15 ATE LIC MANHOLE REFERENCIE LICE, CLASS No. DESCRIPTFON OF WNRK FEE TYPE OF C_ONNF -,F-T!ON LENGTH FROM HOUSE SEWER CONNECTING TO Y. CLIRB, F.L. M.L.TO P.L. PURL!C:SEWER @ $5.00 -' — P.C.NO. 5E TFECANK.-5 EEPAGE-PIT OR JOB N© PITS AND/OR DRAINFtELO @ $10.00T. CO.IMP NO. , D, �l- HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM $3.00 CONn ECT ADDITIONAL BLDG OR MSTR.NO DATE 0 _WORK TO HOUSE SEWER @ 33.00 OVERFLOW SEEPAGE EXTN CESSPOOL.DRYWELL.MANHOLE $5.00 HWY OR$T.WIDENING 0 ALTER*-RIEVA-FROR ABANDON HOUSE � ...... SEWER OR DISPOSAL SYSTEM @ $3,00 --STWT ENCROACHMENT PERMIT NO. Lu iL INDUSTRIAL WASTE APPROVAL_�_ Z I_ 2 0MrNER7-s- -pnM--lT---- 2 00 -- CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR_)R T CONNECT' THE ABOVE DESCRIBE EXISTING DWELLING PUBLIC 1 DATE INSPECTOR SIGNATURE: TO THE UBLiC SEWER- APPROVALS SIGNED THi DAY OF OWNER OR NEW HOUSE SEWER OWNERSAGENT CONNECT ADDITIONAL ADDRESS 01JLDING OR WORK SEPTIC TANK.SEEP,PIT(S) H 3 EREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ----.- - ___ i WITH ALL COUNTY ORDINANCES AND STATE: LAWS REGULATING I CESSPOOL ❑ oRYWELL I HERE CERT: -;PAIR.SEWER OR FY THAT f AM FROP]ERL,� REGISTERED AND/OR ALTER;RE LICEN*ED A5 REQUIRED BY LOS ANGLE. .1.1TY AND STATE OF SEWAGE DISPOSAL SYSTEM AL'FOR 'Ar '] AM .T H I,, OV,F C AL IOW & F, AND INTEND TO DISC E�ET PLUG ANC RES,DE TH C AS DESC0�0 R SIDE TIAL PROPERTY.ry ASANODON HOUSE SEWER $!G TU 'L. E P_--ALL,SEPTIC TANKS, F E E CESSPOOLS ❑ 0 T SEEP. IT S) VALIDA-7- 17: JACK R. ALLEN SUPERVISING MECHANICAL ENGINEER CK. M.O. CA SH ON A