HomeMy Public PortalAbout6225 OAK AVE_Sewer__ Cf`�•d��e Cr,r: �5 � •rIL��'e
-XIWA W s OF ' S WER EWAfiE p1 POSAL
SMSIox�" or TAB"AND�BAFSTYS � P RMIT APPLICATION h
WILLIAM d. FOX, COUNTY EN■INE m DUSI'La O
AooREMS
LOCAu 1
WILDINGT11 APPLI` IN NEANEOT
MDRESS ': GROSS CIT.
LOCALITY DIUMOT DENIAL N0. PROWT HO.
r _ .. �.— A Z _S
�. EIYED BY RnO►far Ittlw DATE ISSUED
OINNR! s -
ADDRESS USL OCCUPANCY MK MAP PS
CITY TEL O fir"u
CONTRACTOR
ADDRESS W. J e, • - JOB N0. r
0",.= TELNO.: `" .t'( THUNK PERMIT 1110.
n
REGISTRATION M. COUNTY ROAD PERMIT NIL tilp
D LE/CRIPTION LOT N0. 6- c , 'A�EI�O■OAON■RMT FM
14u a INDUSTRIALr1
' _ WASTE APTROYAL •-�- -000
Suz OF LOT /a's XIS
now OM LLO t Nee..C SHAMES
T
■�UILAINSS 1.. e, p,�t 1 Y, e. MNN AMt FEt
NO. me D1011CRIPTION OF WORK FEE
NEI■■UNs■ENT F
PUBuOGEMIER N SJ■ `"6 ■EOEIFTNL TE NF
P PATE D SYSTE■TO I.N
RECEPTIONRtooBo
TO NOOSE SEMIEB I.N
• DATE
SEMI"OR 7A bSAL=1■ 1419
AN I.M OONNBCTION DATA
UWW
m Us PIT an
PITC AND R NAINFIRM >w STATION ••4 r ��'• DEPTH 1
OF
AL ONLY l.SS 0 ■AMMO�VENCs LOWER
TYPE OF COHNROTIOM LENGTH FRO■
oymms 11MMIT i 1 00 LTO RL
AU MORQATION TOTAL F c
1 HAVE THIS DATE CONTRASTED WITH THE RE■EIN NA■ED `
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED STING APPROVALS 1 tOTOR'S UONATUOR DATE
DWELLING,TD TMs MIBuO SEINER
SIGN®THI DAY Of 10i WN
HppEMI NOUOE stINE■ �.�: '' .
owNER sR S-=t, �-. .,..�.. . BIINLDi Y ORDICIKNAL
OMINtp MINT
ADDRESS Aro OR GRAINFIELD PIT(11)
1 HEREBY ACKNOWLEDGE THAT 1 HAVE WAS TRIG APPU. CESSPOOL[3 DBYMIELL 0
1 IIL■FCATIONLY PTH NrND STATE THAT TH
UN ME NANCES CORRECT STATE SLAM1i �, R
u GAOEItp Al SSYSNTL■
1 HEREBY CERTIFY THAT 1 P PELOS ANSB 6 TY DISCONNECT PLUG AND
AND ESTATE CADLIFOANIA OR THAT 1 A■ THE LEGA 01N1• ABANDON HOUSE StNItR
NO Or TMs ABOVE OM NAGUILLIZffSIG
rAEA _ GSERPIT011 OEO IPS r'k �lit..IrY
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TGAOMA 0■ t/M{
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ieAE '
£-0-6'83 fi-83 APPLICATION FOR PERMIT 1
3&
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ' ,�,+,_ ! � '.:''1'fi
CASSAT'T D. GRIFFIN, SUP'T or BUILDING LOCALITY
FOR APPLICANT TO FILL IN doss s.
LEGAL t - -
DESCRIPTION LOT NO.�X ,.2 — �?�. � OWNERMAIL
BLOCK TRACT - ADDRESS
NO.OF BLDGS.
117E OF LOT NOW ON LOT CITY c TEL. N0.
USE OF ^ � i
BUILDINGS i',a n/"�g DISTRICT N0. - GROUP _ BK MAP Pa
.Y
41
C014TRACTOR
a CONNECTION DATA
ADDRESS
-- -- STATION - , DEPTH
CITY '-L , S - TEL N0.^
.,.`�.. ---. �. j .. _— MANHOLE REFERENCE,.` _ cUPPER
Z' -STATE -_-. LOWER
.REGISTRATION N0. SIJ -= j .:�.... `I] COUNTY ----------`_��- i - - -
�.,...,i—. —..—
No_L DESCRIPTION OF WORK -- —FEE"--- ---- --------- -------------
( HOUSE SEINER CONNECTING TO ,�- TYPE OF CONNECTION LENGTH FROM
PUBLiC SEWER @ Y. CURB P.L. M.L.TO P.L. u -_ ---
S 3.5 G i > -L. — --
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR_DR_AINFIELD _ acs $3.G0 -
OVERFLOW SEEPAGE PIT,DRAINFIELD --I— --- --W - ---^-- P C N0. ='
EX!'N„CkS5P0.0_L,DRYIVE'LL,M_AN_HOLE_Ci� j 2.00 I �. _CO3 IMP. N_0_, 433#Cr,__
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM (cE $I.GO Y_j- TRUNK PERMIT
— NO. - ROAD PERMIT NO.
-"--7+ --- ---- - - ---------'--- ----- --'---`---------
CONNECT ADDITIONAL BLDG,OR ! I STATE ENCROACHMENT
WORK TO HOUSE SEWER (q' S 1,00 PERMIT NO.
i ALTER,REPAIR OR ABANDON HOUSE -----------------------_ �..--^-^---------
T SEWER OR DISPOSAL SYSTEM r t`OD INDUSTRIAL
--_.__.- -------------------- I----- ----- WASTE APPROVAL
CHARGES
—_-----_--- ' -T ..._ CONNECTION CHARGE FEE
OWNER'S PERMIT $ , i 00 - —--—------- -- -' ------ ---- ------
AUTHORIZATION ^TOTAL FEE-- REIMBURSEMENT
EEREIMBURSEMENT FEE
I
I HAVE AT THIS DATE Fl CONTRACT WITH THE HEREIN NAMED COIN- ______ APPROVALS DATE INSPECTOR'SSICNAT'URE
'I RACT'()R 'f0 CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -
YO THE PUBLIC SEWER. NEW HOUSE SEWER
SIGNED THIS A)AY OF. —1D GQNNEGr ADDITIONAL
OWNER OR � * � gw,a.- BUILDINGORWORK
._---,--`-.-_-._�- -
OWNERS AGENT --
'L —"---'�---' SEPTIC TANK,SEEP,PIT(S) '
AU:URE S—-
AND/OR DRAINFIELD -
1 HEREBY ACKNOWLEDGE THAT , HAVE READ THIS APPLICATION CESSPOOL. DRYWELLE] �
AND STATE 7"H- r .HL ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAVA`„ 'ING ALTER REPAIR,SEWER OR i I -
PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REG157ERED AND;OR r _ - I-
DFSCONNECT PLUG AND
U CENSC AS RE0[.iRED BY LOS ANGELES COUNTY AND STATE OF V
ABANDON HOUSE SEWER
CALIFORNIIA OR THAT I ANI Tt}£ LEGAL OWNER OF THE ABOVE
DESCRIn.Ep RES DENTIAL PROPFVTY, e. e7 BACKF LL SEPTIC TANKS L, —i --- ---
SIGNATURE "` :' � � .+ _SEEP. Pt (S) L J CFSSPOOL '- ___--
_ ,� .
OF PERMITTEE
JOHN A. LAMBIE, Co- 17r 1 NGINEER _ VALIDAT'ION ROBERT A.WOOD, CHIEF PLBG, INSPEc"TOR
160