HomeMy Public PortalAbout6616 OAK AVE_Sewer__ 'sAg 2° APPLICATION FOR PERMIT
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DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Englneer
County of Los Angeles BUILDING
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JOHN A. LAMBIE COUNTY ENGINEER — —
LOCALITY
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NEAREST
FOR AP LIC4N'T T4 FILL IN _ ROSS Sr_
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BLOCK —_ 7R.AC �-_,�- ------- 1:DURESS -- f•J _t...��:_
NO. -✓ .-_
SIZE OF LOT NOW ON LUT CITY _ j TEL. NO,
USE OF
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BUILDINGS � �? Y'Y _�' �_ "'+`-i' tY DISTRIC`T NO. I GROUP I MAP
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ADDRESS T f --- CONNECTION DATA -
r- STATION _ +'. .'-� DEPTH _
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C.!'3'Y MANHOLE REFERENCE .,+ + n -....IIPP R .
STATE
REGISTRATION NC— COUNTY --. .__ -
NO DESCRIPTION OF WbRh FE TYPE,OF � CTION LENGTH
I U SEWER CONNECTING TO
7CyURB o
'L. NL.S:WE� TO '—,.–L-.—.
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SEPTIC TANK,SEEPAGE PIT OR
.__i. PITS AND/OR URAiNF2ELD n• W 3.00
OVERFLOW SEEPAGE PIT,DRAINFIELD y E C. N0,
E EPIC,CESSPOOL,OR Y b ELL, A.NHO LE (7J $2.GO i j +_G.. IMP. NO. /.. _y 4._ JOB No. ----.-- --. _.
HOUSE SEWER CONN TIP G TO S> ,
PRIVATE DISPOSAL SYSTEM (� $I.0'l K BUNPERMIT NO ROAD PERMIT NO
4
---� CONNECT ADDITIONAL BLDG.OR I STATE ENCROACHMENT'
WORK TO HOUSE SEWER 1.0 DU PERMIT NO.
_— –
ALTER REFAIR OR ABANDON HOUSE I N -._ _ _ -- ----- ---
DUSTRIAL
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I SLCR OR DISPOSAL SY +EM Citi. $1,00 I. _—_I-. .._,_ iY,457E APPROVAL -
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT S I f,- 00 -—.
_.---- -- �;.- -- REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEIN � . c,6
1 HAVE AT THIS DATE A. CONTRACT W[TH IE HEREIN NRNAMEDCON APPROVALS I DArE !NSPECTORSSIGN,ATURr_
TRACTOR 7'0 CONNECT THE ABOVE DESCRIBED EXISTING DWELLING _
TO 1"n E PUBLIC SPI ETt.. `^ r NEW HOUSE SEWER .
SIGNED THIS_, -DAY(DF I i'' �t`I 199 �OrINtC+ ADDITIONAL - ---� --
OWNER OR BUILDING ORWC
OWNERS AGETiT,�.%:.�.�,�._,_. " . • , i:,., _._._._.------...------
- `�'- �r-- � -- SEPTIC TANK,STEP,PIT(S) I
ADDRESS. .., f:.` 3y ANG/OR URAIN.FIELD
I DHEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION CESSPOOL Lj DRYWELL0 I--
AND STATE THAT THE ABOVE TS CORRECT AND AGREE TO COMPLY -_____ _-__-. _ I
WITH ALL 'COUNTY ORD NANCES AND STATE LAWS REGULATING ALTER REPAIR,SEWER OR
PLUMBING AND 5P- RS SEWAGE DISPOSAL SYSTEM
1 HERESY CERTIFY THAI 1 AM P20 PERLY REGISTERED ANO.'OR --- - - 'i -------- -- ------.__.._
1_.EN e7 A REQIJfR D 8Y 'OS ANCELES OUN� 7CN E7 TATE OF DISCONNECTPLt,[ ANDI
CALIFORNIA OR IHAT I \71 t F LEGA OW - R Ot TNF: ABOVE ABANDON HOUSE SEWER I_
DES'RIBED RESID I I'.A�,h ROPERT,. BACKFILL SEPTIC TANKS 0
,..GNATUIZE G'\ SEEP.PIr(si L CESSPOOLS I1 I
OF PFRMITT'" - . „ >--> ;_d' .------ I ----- ------ ------
ICHN A. I...AMBIE, Col! Y ENGINEEFdr1LIDA Tim I�CDEIRT A.WOOD. CHIEF'PL8G, INSPECTOR
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CIS, M ., CAI;14
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