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Home My Public Portal About5725-5727 NOEL DR_Sewer__ �00 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-7-SEWAGE DISPOSAL DEPARTlMT OF COUNTY ENGUMM BUILDING AND SAFETY DIVISION ABUILDING DDRESS15-1 1 OHN A. LAIMM L County rr D QRIT r B t alp LOCALITY FOR APPLICANT TO FILL IN CROSS s ' LEGAL DESCRIPTION LOT NO OWNE BLOCK TRACT AD REQSNO SIZE OF LOT I b V LO-26NOWON LOTS A- CITY TEL NO �` r USE OF t BUILDINGS DISTRICT NO i GROUP MAP CONTRACTOR 0Nn G ADDRESS 2+ , CONNECTION DATA CI TEL NO L_ g STATION DEPTH STATE MANHOLE REFERENCE UPPER REGISTRATION NO COUNTY LOWER NO DESCRIPTION OF WORK FEIM HOUSE SEWER CONNECTING i0 PUBLIC SEWER SEPTIC TANK SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM PITS AND/OR DRAINFIELD W $300 CURB- P L L TOP L OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE 0 $200 HOUSE SEWER CONNECTING TO P C NO PRIVATE DISPOSAL SYSTEM W $100 CO INP NO JOB NO WORK TO HOUSE SEWER Q 1 00 TRUNK PERMIT NO ROAD PERMIT NO - — ALTER REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM 100 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL A CHARGES Ovmm s Pmwr $ O CONNECTION CHARGE FEE AOTHORPl.ATION =oTgL pgg . ®� REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR S SIGNATURE _ TO THE PUBLIC SEWER SIGNED THI DAY ) NEW HOUSE SEWER OWNEROR - CONNECT ADDITIONAL OWNERS A BUILDING OR WORK ADDRES .� 'r' -SEPTIC TANK SEEP PITS) AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION r AND STATE THAT THE-ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS ALTER REPAIR SEWER OR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEM -- LICENSED AS REOUIR BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAX.\PROPEJLTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) Ij CESSPOOLS OF PERMITTE ®� UMATION ROBERT A WOOD CR r 0 CASK SUPERVISING MECHANICAL ENGINEER 1512AJAN 5 1 0 A 300 APPLICATION FOR PERMIT 1 COUNTY OF LOS ANGELS$ SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY MGM= MWING AND SAFETY DMSION BUILDING TOM A. LAM13L CemtF � ADDRESS � CABU T D GM"M s t of 8n�ldlsp LOCALITY FOR APPLICANT TO M ]N NCn ss LEGAL s DESCRIPTION LOT NO OWNER BLOCK TRACT NAIL r ADDR NO OF SLUGS SIZE OF LOT NOW ON LOT CITY ~ TEL NO t� USE OF BUILDINGS DISTRICT NO GROUP NAP i K PG CONTRACTOR ADDRESS CONNECTION DAYA CITY TEL NO 16A &CO STATION DEPTH STATE MANHOLE REFERENCE PPER REGISTRATION NO COUNTY h No I DESCRIPTION F WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ S S50 TYPE OF CONNECTIO LENGTH FROM SEPTIC TgNK SEEPAGE PIT OR Y CURB P L M L TOP L PITS AND/OR DRAINFIELD @ $ S 00 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE 0 $2 00 HOUSE ef PRIVATE DISPOSAL SER YSTTING O o TEM @ $1 00 CO IMP NO OB N0 �� CONNECT ADDITIONAL BLDG OR WORK TO HOUSE SEWER 0 $1 00 TRUNK PERMIT NO ROAD PERMIT NO ALTER REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM S1 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL g _ -� WASTE APPROVA G� CHARGES OWNER s PERMR i z.. 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE I ) REIMBURSEMENT FEE za 1 HAVE AT-THIS DATE A CONTRACT WITH THE HEREIN NAMED CON TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTORS I ATURE TO THE PUBLIC SEWER _ SIGNED THIS - DAY OF 19 NEW HOUSE SEWER OWNER-OR ,JJ BUNLDING OR WORKAL OWNERS AGENT ADORE SEPTIC TANK SEEP PIT(S) AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑ WITH ALL COUNTY ORDINANCES-AND STATE LAWS REGULATING PLUMBING AND SEWERS ALTER REPAIR SEWER OR I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEM LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF-THE ABOVE ABANDON HOUSE SEWER _ DESCRIBED RESIDE TIAL PROPS t BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PITS ❑CESSPOOLS ti OF PERMITT ®r — VMMATIROBERT A WOOD C6 ■ ° CAfN SUPERVISING MECHANICAL ENGINEER it 17269 DEC $ 10 A x600