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HomeMy Public PortalAbout5314 NOEL DR_Sewer__ DEPARTDWNT OF OOUP= ENGMER SEWER--SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION C*UZ TY OF LOS ANS ILDING WILLIAM J FOX. COUNTY ENGINEER ADDRESS 13 BUDRESS FOR APP LI N TO FILL I LocALITY BUILDING NEAREST ADDRESS CROSS ST LOCALITY DISTRICT NO SERIAL©NO PERMIT NO NEAREST Q 9�v 49 S CROSS ST RECEIVED Reads for laepedloo DATE ISSUED OWNER 3 MAIL USE ZONE j OCCUPANCY BK MAP PG ADORE CI TEL NO e5 CONTRACTO 1377 - 3 /4 CO IMP NO ADDRESS JOB NO CI 40-7TEL NO STATE/ TRUNK PERMIT NO REGISTRA ON NO COU TY3 ROAD PERMIT NO LEGAL / STATE ENCROACHMENT DESCRIPTION LOT NO PERMIT NO BLOCK je TRACT �f f� INDUSTRIAL SIZE OF LOT NO OF SLOGS Aft NOW ON LOT 4 CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO DESCRIPTION OF WORK FEE - REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER R 850 RECEIPT NO DATE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 100 CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED WORK TO HOUSE SEWER 100 NO ALTER OR REPAIR EXISTING DAT BY SEWER OR DISPOSAL SYSTEM 100 AND ORNDISPCT 08AL ABANDON SEWER 100 CONNECTION DATA SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 200 / MANHOLE REFERENCE UPPER 40( TYPE OF CONNECTION LENGT M OWNERS PERMIT :I I 00 CURB -JL5-- ml TO L O AUTHORIZATION I TOTAL FEE O 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE EWRISED EXISTING APPROVALS INSPECTORS SIGNATURE DATE DWELLING TO THE ELIC SEWER SIGNED THIS Y OF NEW HOUSE SEWER py;25 OWNER OR CONNECT ADDITIONAL OWNERS AGE BUILDINQ OR WORK SEPTIC TANK SEEP PIT(S) ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL[3 DRYWELL CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWER OR REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT THE LEGAL OWN ER OF THE ABOVE-D _ IBED E NTIAL P OPERTY BACKFIEU-S-EPTIC TANK SIGNATURE SEEP PIT(S)[] CESSPOOLS OF PERMITTEE 76A642D 603 1/58