HomeMy Public PortalAbout5587 NOEL DR_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J FOX, COUNTY ENGINEER BUILDING
ADDRESS 5W7CABBATT O GRIFFIN BUPIT OF BUILDING A1,
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FOR APPLICANT T F IN LOCALITY _
BUILDING �� ^y�r f'�_'} NEAREST
ADDRESS ' _L�(/`T GROSS ST r
DISTRICT NO v SERIAL NO PERMIT O
LOCALITY r? / c
NEAREST A 2_( J
CROSS ST RECEIVED BY Ready for lospedlon DATE(ISSUED
OWNER AA , — -- /_
AMAIL
DDRESS USE ZONE I OCCUPANCYB MAP P
CITY ` EL NO
CONTRACTO CHARGES IMBURSEMENT FEE
ADDRESS ' REQUIR
NOT REQUIR
CITY EL NOFF^� � CONNE N CHARG_E FEE
REGISTRATION NO�3 �"1 �[� COUCO IMP NO
!;p o 2
LEGAL340 G RECEIPT NO I DATE i BY
DESCRIPTION LOT NO '7
BLOCK TRACT �� - WAIVER FOR RECORDING
SIZE OF LOT 51 3U NO NOW ON LOTS RECEIPT NO DATE BY
USE OF
BUILDINGS TRUNK PERMIT NO
NO nFUrNtIPTIMN OF WORK FEE
TIOUSE'SEWER CONNECTING-TO _ - - ROAD PERMIT NO
PUBLIC SEWER ! = 850, T
HOUSE SEWER CONNECTING TO STATE ENCROACHMENT
PRIVATE DISPOSAL SYSTEM 100 PERMIT NO
CONNECT ADDITIONAL BLDG ORINDUSTRIAL
WORK TO HOUSE SEWER 1 00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM ' 100 CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 I STATION DEPTH--�
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 200 I MANHOLE RE ERENCEjo OPLOWER-
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 200 TTYPE F CONGNEM CCTION ns P L LENGTH p� M O
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OWNERS PERMIT ; 1 00 —
AUTHORIZATION I TOTAL FEE S-
WITH THE HEEINAED
CONTRACTOR TO COHAVE THIS DATE ECT HCONTRACTE AVED E DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER •
SIGNED THIS Z6 DAY OF Ah I9S q NEW HOUSE SEWER
� CONNECT ADDITIONAL
OWNER OR UILDING OR WORK
OWNERS AGENT
�j as AND%OR DRAINF ELD CTANK BEEP PIT(S)
ADDRESS 1 7' _
I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLI- CESSPOOL❑ DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWER
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN
ER OF THE ABOVE D RIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS
SIGNATURE SEEP PIT(S)[j CESSPOOLS[] y
�
OF PERMITTEE _
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