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HomeMy Public PortalAbout6320 OAK AVE_Sewer__ ts S&E.e83 tt.55 APPLICATION FOR PERMIT 4&6.6 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE D{SPOSAL Department of County Engineer County of Los-Angeles BUILDING >„r •", . ,r ,, JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS , . - i- iD CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CRROSSS T. wy -_--�__ LEGL DES RIPTION LOT NO. £sp S' '- OWNER - ..•4 f,YJ _ry .'°"d,a MAIL BLOCK - TRACT ADDRESS 4. N0. OF BLDGS. SIZE OF LOT- _ NOW ON LOT CITY x::�.,,.�` �_.a.r., � TEL NO USE OF r„_,... �. DISTRICT NO GROUP MAP BUILDINGS_ - >. "� -- I BK PG CONTRACTOR CONNECTION DATA .ADDRESS ------ - - -STATION ". Y � DEPTH °,__-___- CITY - STEL NO. — - -- MANHOLE REFERENCE _ ... ❑ STATE— LOWER REGISTRATION _ REGISTRATION N0. COUNTY Nf?. DESCRIPTION OF WORK� FES s -- ------- - - --- ---- ----" ---- ---------- TYPE OF CC' �CTION LENGTH FROM HOUSE SEINER CONNEG,T.NG 70 -i I ->`I Y. RB P.L. M.L.TO P.L. c --¢�-. PUBLIC SEWER- _`-$3.50 ----- -- -- SEPTIC TANK SEEPAGE PIT OR ----IPITSAf`IDrORDRlaIN=IELD ('i §3._0_0_+4_ _ --- - --"-- ----_.. CVERFLOV S EPACE PIT,DPAINFIELD j�- P. C; NO. EX N.,CFSSPOOL.URNwELL,MANHOLE 5 21.00� � __CO. IMP. N0. Z _ 10B N0._ HOUSE,SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM_ (rx 1.00 I�--+ TRUNK PERMIT NO. - ROAD PERMIT NO. - - CONNECT ADDITIONAL BLDG.OR j STATE ENCROACHMENT --- WORK TO HOUSE SEWER teel" 5.1,Q0 PERMIT NO ALTER.REPAIR OR ABANDON HOUSE ._.__- .. OR DISPOSAL SYSTEM Ga 3 I.O -- __^-- INDUSTRIAL _---- _ — 1 _-- _--- -- _-- �-- -- t _- _ WASTE.APPROVAL CHARGES 1 ' --.----__.._-- ------- CONNECTION CHARGE FEE PEOWNER' i -.-.—_. ---- ---- ------' ---------- .'9 IiAiiT $ I L ©0 1 REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE �—^—��1d = APPROVALS I DATE NSFF,CTOR'SS1GNA7URF. I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- ._.--_._-------------_--_--_-_--�_ J---_-_.__ TRACTOR 70 CONNECT THE ABOVE DESCRIBED EXISTING DWELLING F TO THE PUBLIC SEA E,$. NEW HOUSE SEVER SIGNED THIS-4L.4—DAY OF CONNECT ADDITIONAL OWNER OR OR BUILDING OR ''PORK OWNERS AGENT 4. ` '', r ,:.s. __.-_ - _.----- - __.--------- — ---__ ------- "------ SEPTIC TANK,SEEP, PIT(SI J ADDRESS—- -:a - _y -` AND/OR DRAINFIELD - - 1 SF3 H RY ACKC0 .N ',,LEDCE HAT I PAVE READ THIS APPLICATION - ' AND STi,TE T^t11 THE ROVE t; CORRECT AND ACREE TO COMPLY CESS°DOLL; DRYVJELL❑ I j WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR SEWER OR --' — PLUMBING A;ND SEWERS. .SEWAGED:3POSALSYS7EM - I H CLFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND-----�-----�I- --_ LICE r" ;'.5 REQUIRED 13Y LOS ANGELES COUNTY AND STATEOF CALIFORNIA OR AM THE LEGAL C!^.-NERABANDON HOUSE SE>WER- CF THE ABOVE --- DESCk 8'e.D RES'. ATIF,I aOPER7! BACKFILL SEPTIC TANKS ] SiGNATUtZ_ - - OF PERMITTEE._.-- -T_ r-..---- --- EEP F 17 S1 ! CLSSPOJLS 1 , 1 JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION DOSE PT A. WOOD, CI-HrF PLE'G INSPECTOR CK. b.0, CASH , f ;