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Home My Public Portal About5741 NOEL DR_Sewer__ DFPARTBDMgT OF COUNTY ENGINEER r SEWED—SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDINGV,C Z "/V S/yC WILLIAM J FOX, COUNTY ENGINEER ADDRESS TT I/ ( J/1 /�// Y FOAPPLICA T TO LOCALITY BUILDING RSS ,? /W� 64t C_/ CROSS ST y 'YLr a LOCALITY E ClDISTRICT NO SERIAL NO /PERMIT NO c NEAREST w,+ A fV�� J CROSS ST 0 �,,/r Y C Ready for taspeotion DAT S8UE_D OWNER C , ��[[ // 40 I/V�- // S ADDRESS .J 77/ �D� 4O /t, 51 USE ZONE OCCUPANCY BK NAP PG R - I CITY rAdOf e C/rTELNO (� G. /3 �� CONTRACTOR '/ f/ CO IMP NO ADDRESS f'3OO 'E"s'/��[LE�/ ��✓O JOB NO CITY TEL-310 T 1-12,1, STATE TRUNK PERMIT NO REGISTRATION NO Q 2—8 ROAD PERMIT NO S DESCRIPTION LOT NO , �C5 # f, STATE ENCROACHMENT PERMIT NO BLOCK TRACT � �� WASTE APPROVAL SIZE OF LOT OX,e NOW ON LOTS CHARGES USE 1oE111c,C- 104 14 If,4 CJr CONNECT ARGE FEE NO DESC IPTION Or WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER ! $ 350 IS' RECEIPT NO TE BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 100 CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1 00 NO ALTER OR REPAIR EXISTING DATE BY SEWER OR DISPOSAL SYSTEM 100 AND/OR DI8P SAL AND SYSTEM SEWER 1 00 CONNECTION DATA SEPTIC TANK SEEPAGE PIT OR /) PITS AND/OR DRAINFIELD 200 STATION �L C/ DEPTH CESSPOOL—D RY W ELL SPECIAL CONDITIONS ONLY 200 MANLiOLE REFERENCE _MW LOWER TYPE OF CONNECTION LENGTH FROM _ OWNERS PERMIT 1 I w Y CURB !ir L ML TOP L -AUTHORIZATION TOTAL FEE SO -1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TNDWELLING TO ONNfC C HE ABOV DESCRIBED EXISTING APPROVALS INS PEC OR 8 SIGNATURE DATE ER SIGNED THISSDA F NEW NOUBESEWER (� ►��K OWNER OR CONNECT ADDITIONAL OWNERS AS j_ BUILDING OR WORK ..`` SEPTIC TANK SEEP PIT(8) ADDRESSAND/ORDRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVER D THIS A 1 CESSPOOL[] DRYWELL CATION AND STATE THAT THE ABOVE 18 CORRECT AND A EE TO COMPLY WITH ALL COUNTY ORDINANC SAND STATE WS ALTER REPAIR SEWER OR REGULATING PLUMBI G AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERT MAT ,PR ER REGISTERED - AND iLICENSED A8/REG B L ELES COUNTY DISCONNECT PLUG AND AND STATE OF C F RNIA M E LEGAL OWN AS NOON HOUSE SEWER ER OF_THE AB 8 1 TI PROPERTY BACKFILL SEPTIC TANK i� SIGNATURE SEEP PIT(S)[] CESSPOOLS 14 v OF PERMITTEE 76A642A 663 7/53 if Q cascoAPPLICAT ON FOR RMIT ceaos n s so COUNTY OF LOS ANGELES SEWER SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINiEEEB BUILI)I iG AND SAFETY DIVISION ABUILDN DD E SG A/ JOHN A. LAmm County sagmew CASSAT!D GRIFFIN Sup t of Buddmg LOCAL)TY NEAREST FOR APPLICANT TO M IN CROSS ST An LEGAL DESCRIPTION LOTNO . OWNER t BLOCK TRACT NAIL ADDRESS S geP At 6dJ NO OF BLDGS SIZE OF LOT NOW ON L CITY -9,dAve, GAJ a✓d'EL NO USE OF BUILDINGS DISTRICT NO GROODUPI BK YAP^ / PROCESSED BY CONTRACTOR �� G �C �.� V rL. Z-1 /o1GV ADDRESS .S CONNECTION DATA CITY j/t� TEL NO /�/`—��r STATION DEPTH STATE MANHOLE REFERENCE UPPER REGISTRATION NO O COUNTY LOWER NO DESCRIPTION OF WORK FEE PUBLIC SEWER WESEWRCONNECTING TO G $300Atw SEPTIC TANK SEEPAGE PIT OR TYPE OF CONNECTION LE 6TH FROM PITS AND/OR DRAINFIELD 0 $3 00 Y d=4CURB L N L TO P L OVERFLOW SEEPAGE PIT DRAINFIELD Z " EXTN CESSPOOL DRYWELL MANHOLE ! $200 HOUSE SEWER CONNECTING TO P C NO PRIVATE DISPOSAL SYSTEM $1 00 CO IMP NO JOB NO WORK C HOUSE SEWER R 1 00 UU TRUNK PERMIT NO ROAD PERMIT NO SEWER OR DISPOSAL SYSTEM HOUSE 0 $1 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNER$ PERNIIT 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE 3 lod, REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS DATE INSPECTOR S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL t OWNERS AGENT BUILDING OR WORK ;36 k NK SEEP PIT(S) ADDRESS RAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLYL❑ DRYWELL❑ WITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGEPAIR SEWER OR PLUMBING AND SEWERS DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/ORECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVEDESCRIBED RESIDENTIAL PAOP (S ILL PDC CESS 00❑lS SIGNATURE OF PERMITTEE �r ALIDATION ROBERT A WOOD cK H o CASH SUPERVISING MECHANICAL ENGINEER L r" 3 0 5 0 -J-130 1 0 p 300140 " ofar/