HomeMy Public PortalAbout6253 MUSCATEL AVE_Sewer__ D
Sa.E-068 it-SS APPLICATION FOR PERMIT 1
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DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS —
CASSATT 0. GRIFFIN, SUPT of BUIL9ING LOCALITY
FOR APPLICANT TO FILL IN CROSS s
LEGAL -
DESCRIPTION LOT NO. OWNER
BLOCK TRACT MAIL
ADDRESS
NO. OF BLDGS, -
SIZE OF LOT 'r' NOW ON LOi CITY T'EL NO.. -
USE OF - -
BUILDNG" DISTRICT NO, i GROUP MAP
I
CONTRACTOR _ I -
CONNECTION DATA
ADDRESS -----------'------
aT`d.TION ❑EPTH
— -�
CITY TEL. NO. 'AANH3TLE REFERENCEEj U•YPER
STATE -_ ___LOWER__
REGISTRATION NO, ❑ COUNTY
NO. DESCRIPTION OF VVORK FEE — ---- '=--------------. .. ----- --
---'` - -- -- — --- - TYPE OF CONh�C'eION LENGT'; FROM
f HOUSE SEWER CONNECTING TO Y.
_ f PUBLIC SEVER _ _ — @ $3.50CURB P.L. M ?.:TO P.L.
---� - _.— —. --w--�..—.— _
SEPTIC TANK,SEEPAGE PIT OR
J� PITS AND/OR DRAINFIELD _c. $3,0.0 —
' OVERFLOW SEEPAGE P17, DRAINFiELll �f �P NO.
EXTN-CESSPOOL,DRYW-ELL,MANHOLE Cg. $2.001 I -0. IMP. NO,
JOB':9.
HOUSE SEWER CONNECT ING'TO `.
PRIVATE DISPOSAL SYSTEM .1 $1.00 PERMIT N,r'. — ROAD PERMk N0.
CONNECT ADDITIONAL BLDG.OR -_ -- ENCROA'"CHM4ENT --- -- -WORK'TO
_ .HOUSE SEWER. .. -----$-1.0-0
ALTER_,REYAtk O_R AAN-D—N
HOUSE a - —�-`- -� �:�. ------
SEWER OR DISPOSAL SYSTEM {i. $4.00 ' �i NOU.,T�.IAL
�--.I ------ ..--.-. VASA.-APPROVAL
CHARGES
-- :ONNECTION CHARGE FEE
OWNER'S PERMIT $ 1 oc - -- ---- -- — —
2EIVBURSEMENT FEE
AUTHORIZATION TOTAL FEE
] HAVE AT THIS DATE A. CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING _-- --- ---- ------�_^..—_
TO 'IRr PUBLIC SEWER, - VEW HOUSE SEWER
SIGNED THIS DAY GNNEC:ADDITIONAL�
OWNER OR 3UILD NP OR WORK
OWNERSSEEP. PIT(S3
.ADDRESS — _1ND/Ok_DRAI_NFIELD
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPL1CATI aESSF60l❑ URYW ELL.L�.�
AND STATE THAT THE ABOVE I5 CORRECT AN6 AGREE TO COMPL.'�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER.REPAIR,SEWER OR j — --
PLUMBING AND SEWERS. i
,iEWAGF.DISPOSAL SYSTEM I
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR -- -- ---- -----^I----- -----
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF '7ISCONNECT PLUG AND
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE IBANDON HOUSE SEWER
DESCRIBED RESIDENTIAL PROPERTY. AACKFILI,ScriTG AnK.L1 _. I
SIGNATURE CESSPOOLS
OF PERMITTEE
_ I
IOHN A. LAMBIE,COUNTY ENGINEER VALIDiiT..O Iy ROBERT A. WOOD, CHIEF PLI3G. INSPECTOR
CK. M. 0: r.A:,;..
R� h'
E.eE
6420&E-6E�7�.5d APPLICATION FOR PERMIT 1
6 S:
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUILDING
WM. J. FOX. COUNTY ENGINEER ADDRESS - - s > -y �``y, ..;, ,.✓,.. _.
CASSATT D.GRIFFIN,SUPT OF BUILDING 9 i
LOCALITY
FOR APPLICANT TO PILI. IN
NEAREST
FOR
CROSS ST.
LEGAL ,. — — dX
DESCRIPTION LOT NO...: . „;.,,�° M--°; p.. OWNER �.`
BLOC: TRACT J, ;, .. 1
ADDRESS
f ; " NO.OF BLDGS.
SIZE OF LOT_.,✓ 4-' NOW ON LOT �._-' CITY '$. at.r �.d �TEL, NO.
USE OK
-_ ? � DISTRiCY_NO. I GROUP I MAPCONTRACTOR .. 2 ark c, j BK c0.
ADDRESS CONNECTION DATA
CITY�R;{ t' gyfEL. NO.pw�'.*,d` ''� �'! c'' q� �.s,.- ;TATION_J -:.'. � DEP?H �.
'�fr--+c esu_ S 2--•—• -`— - - - - - --
,. C STATE - MANHOLE REFERENCE
r
REGISTRATION NO. ,J� �. i COUNTY _ _� _ =G LOWER
TYPE,S'•F- ^PN•N="CTiON LEND ri FR '�
NO, i DESCRIPTION OF WORK FEE /' cu a P.L. _ M.L.To P.L.
9' '—HOUSE SEWER CONNECTING T9
f _ PUBLIC SEWER _ c J-3-50
HOUSE SEWER CONNECTING TO j
PRIVATE DISPOSAL SYSTEM _-----
�� CONNECT ADDITIONAL BLDG. OR ' `A CO. IMP. NO. •-� �¢,+ -JOB. NO.
14 OPK TO HOUSE SEWER_ __ i 00 .�°' - �- _•,,,_,_ 6�
ALTER OR REPAIR EXISTING -.4 - .!, �� _
_
SEWER.OR-D+SPOSAL SYSTEM t 00 _I TRUNK PERMIT N0. ROAD PERMIT P�0
- _s
�+
DISCONNECT AND ABANDON SEWER - �J r — ;TATE ENCROACHMENT
_
AND/OR DISPOSAL SYSTEM. 1.00 I >ERMtT NO _
SEP21C TANK, SEEPAGE PCT OR I i�.�
PITS AND/CR DR_AINFIELD 2_00 NDLSTRIAL'
CESSPOOL DRYWcLL ',A ASTE APPROVAL
1.SPECIAL CONDITIONS ONLY
C
BAR GES
- CONNECTION CHARGE FEE
Ovim'B PERMIT o I 11 00 z
AUTHORIZATION TOTAL FEE �i y`'{v 'FIMRORSEMENT FEE
}Fa
_ tr I
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR S SIGNATURE
TRACTOR TO CONNECT'THE ABOVE" DESCRIBED EXISTING DWELLING ___, _�_
TO THE PUBLIC S W _
ER - ^� -' _
SIGNED THIS-- .DAY OF 19� NEW HOUSE SEWER
OWNER OR & _ '* ZONNECT ADDITIONAL -
OWNERS AGEN _ 3UILDING OR WORK_,
>EPTiC TANK,SEEP, PIT(S) --
. ADDPFS. _ _ aNDfOR DR.:lNF1EL.D
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL 0 DRYWELL❑
AND STAT-F. THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY - —
WITH ALL COUNTY ORDINANCES AND STATE LAWS- REGULATING VALTER, REPAIR,SEWER OR
PLUMBING AND SEWERS. >EWAGF. DISPOSAL SYSTEM _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR --- �`-'—
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER
DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS D
f- SEEP.PITS)( CESSPOOLS Q
SIGNATURE g' ,//y . .'.: :. _
OF PERMITTEE T
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
'7 4 t
BY BY
DEPUTY DEPUTY
BY By
Q DEPUTY DEP)