HomeMy Public PortalAbout5611 NOEL DR_Sewer__ DEPARTMENT OF COUNTY ENGnvEEB SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING 1
OASBATT D GRIFFIN Bup•r nF Bumo1N0 ADDRESS
FOR APPLICANT TO FILL INBUILDINLOCALITY
ADDRESS —{.z� 1 , MI`GCi li ; CR088 ST _
LOCALITY JAN , DISTRICT NO SERIAL NO PERMIT ItOf
-NEARESTCROSS 8T A 7 er 12.b S
�p REC IV Y Ready for Inspection DATEISSUED
OWNER A—S_SQ
ADDRESS / ® ��w O USE ZONE OCCUPANCY BK MAP PG
CITY TEL NO �f5
CONTRACTOR CHARGES REIMBURSEMENT FEE
UIRED
ADDRESSU /�_� ��,
ISF NOT REQUIRED
CITY � �� TEL NO JOB NO IgJ42 — CONNEVING"HARGE FEE
STATE 1"4707
Cp IMP NO
REGISTRATION NO COUNTY
LEGAL RECEIPT NO DATE BY _
DESCRIPTION LOT NO 2,
BLOCK TRACT G l/G - WAIVER FOR RECORDING
SIZE OF LOT NO OF BLD68 RECEIPT NO DTE., �, BY
.�J' /�, 12,0—
Z� NOW ON LOT
USE OF
BUILDINGS TRUNK PERMIT NO
NO DESC IPT40N OF WORK FEE
HOUSE SEWER CONNECTING TO ROAD PERMIT NO
PUBLIC SEWER a $ 550 .�
HOUSE SEWER CONNECTING TO PERMIT PERMIT
PRIVATE DISPOSAL SYSTEM 100NO
CONNECT ADDITIONAL BLDG OR INDUSTRIAL
WORK TO HOUSE SEWER 100 WASTE APPROVAL""
SEWER OR DISPOSAL SYSTEM 100 CONNECTION DATA
D18CNE
ONCT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM r 100 STATION DEPTH
SEPTIC TANK SEEPAGE PIT OR I
PITS AND/OR DRAINFIELD 2`00 1 UPPER LE E R CE NBllo
CESSPOOL—DRYWELL �—
SPECIAL CONDITIONS ONLY 200 I TYPE OF CONNECTION LENGTH FROM
I PL ` ML TOPE *3S
OWNERS PERMIT $I _I q0
AUTHORIZATION TOTAL FEE -
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
DWELLINBOTOTTHEDPUBLICTSEWER VE DESORIBED EXISTING APPROVALS INSPECTOR'881QNATURE DATE
SIGNED THIS DAY OF - 'Iq NEW HOUSE SEWER
OWNER OR BUILDING OR WORK OWNERS AGENT feSJ ���`�'_
SEPTIC TANK SEEP PIT(8)
ADDRESS a"' AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI: CESSPOOL❑ DRYWELL 0
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
k' 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/ORr LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND `
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKB� -
SIGNATURE � _ c � _ / ' SEEP PIT(S)[] CESSPOOLS[]
OF PERMITTEE
TOA642D 663 12/52