HomeMy Public PortalAbout5657-5659-5661 NOEL DR_Sewer__ DEPARTDUENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT AV (CATION
COUNTY OF LOS ANGELES I
WILLIAM J FDX, COUNTY ENGINEEBUILDNG
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FOR APP L CA O FI i LOCALITY T—' C-r
ADDRUILDIE&S ! NEACROSS STEST 6�' //�
LOCALITY DIST�RIIC�T NO SERIAL NO PERMIT NO
NEAREST ' V A
CROSS ST RECEIVED BY Reedy for Inspection DATE ISSUE�.Dy/
OWNER �� � 9—.L3 ' rj/
MAIL USS OCCUPANCY BK MAP PG
ADDRESS _ OCCUPANCY
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CITY TEL NO �! I A �/p�3r �l�Y� /voo'
1
CONTRACTO Q. C. 9 to
ADDRESS JOB NO �y/ 9 �� V
CITY TEL NO TRUNK PERMIT NO
RESIST RATION NO / C � COUNTY ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NSTATE ENCROACHMENT
O �� PERMIT NO
BLOCK TRACT mo INDUSTRIAL
WASTE APPROVAL
y3, y, J6Q NO OF SLOGS
SIZE OF LOT'
NOW ON LOT a I CHARGES
USE OF
BUILDINGS CONNECTIO ARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FE
PUBLICSEWER G $ 850 RECEIPT NO TE BY
HOUSES EWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTION RECORD
WORK TO HOUSE SEWE 1 00
ALTER OR REPAIR EXISTING NO I DATE B
SEWER OR DISPOSAL SYSTEM 100
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 200 STATION rj e� d. DEPTH
CESSP00I DRYWELL
SPECIAL CONDITIONS ONLY 200 /3 7,
t 41 ANHOLE REFERENCE OWER
4
OWNERS PERMIT ; I 00
Y TYPE OF URB ECTIONP L M L TO P LOM ,�O
AUTHORIZATION I TOTAL FEE
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECT '8 SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS _ _ _ Y F _ .,. _ ,__19 _ NEW HOUSE SEWER JJj AS
OWNER OR _� _ _ _ _ _ - CONIDING O WORKAL /
OWNERS AGENT _ _ BUILDING OR WORK
t SEPTIC TANK SEEP PIT(S)
ADDRESS _ _ _ _ _ _ _ _ AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL[:] 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY,08 ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIF 0 AT A HE LEG L W
ER OF THE ABOV 'C E S PROP BACKFILL SEPTIC TANKS
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SIGNATURE SEEP PIT(S)0 CESSPOOLS
V
OF PERMITTE
GG
70A042A 063 7/53