The URL can be used to link to this page

Home My Public Portal About5809-5811 PRIMROSE AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING CASSATT D. GRIFFIN, SUP'T OF BUILDING ADDRESS - -� FOR APPLICANT TO FILL IN LOCALITY BUILDING a'„s, r NEAREST ADDRESS GROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEARESTI r A CROSS ST. Z L�ir1' •" Y�`ye_ 1. I �, r RECEIVED BY Ready for Inspection DATE ISSUED OWNER :' I:+' .� �'. r: ,� MAIL� � �� I7 r USE ZONE OCCUPANCY MAP ADORtiSS� — .."y j m z` L} BK PG CITYTEL.NO. CONTRACTOR _ - .I _ 6; CHARGES REIMBURSEMENT FEE ADDRESS ' 1L REQUIRED -Tqq NOT REQUIRED CfCiTYCf' _ �91: y ;V TEL.NO, Y e `s CONNECTION CHARGE FEE TY �==—s--- -- sem -30-B.NO. STATE REGISTRATION NO.r _ 00"TY CO.IMP.NO. LEGAL .,RECEIPT N0, l DATE BY DESCRIPTION LOT NO. BLOCK TRACT WAIVER FOR RECORDING `` SIZE OF LOT ' w NO.OF BLDGS. _ NOW ON LOT 6 RECEIPT NO. DATE I BY USE OF tf BUILDINGS 1 TRUNK PERMIT NO. - NO.I DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO ROAD PERMIT NO, ---•--- -- PUBLIC SEWER _ @ $ 3.50 - HOUSE SEWER CONNECTING TO STATE ENCROACHMENT PRIVATE DISPOSAL SYSTEM 1. PERMIT NO. CONNECT ADDITIONAL BLDG.OR WORK TO HOUSE SEWER _ 1.00 INDUSTRIAL _ - _. WASTE APPROVAL ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM__ 1.00 CONNECTION DATA DISCONNECT AND ABANDON SEWER ANO/OR DISPOSAL SYSTEM 1.00 SEPTIC TANK,SEEPAGE PIT OR STATION DEPTH PITS AND,/OR DRAINFIELD 2.00 MANHOLE REFERENCE CESSPOOL—DRY'WELL I UPPE[i _ ESS' 4r _SPECIAL CONDITIONS ONLY 2.00 ^TYPE OF CONNECTION LENGTH FROM P.L. M.L.TO P.L. OWNERS [-PERMIT $ + f 00 -- - - AUTHORIZATION I-TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS I NSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED TRIS_.-- --------.DAY OF_ w i:. I. _ 19 .N NEW HOUSE SEWER 1 ` OWNER ' CONNECT ADDITIONAL OWNERS AGENT f v.!� 't ...ti.G•Ird BUILDING OR WORK t SEPTiC TANK,SEEP.PIT(S) f AND/OR DRAINFIELD f I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLi- CESSPOOL(� DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER REGULATING PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT IAM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOV CRIBED RESIDENTIA PROPERTY. BACKFILLSEPTICTANKS© r SEEP.PIT(S)E] CESSPOOLS El SIGNATURE '�+ ✓yse i OF PERMITTEE.. ........ ...S .... .. 76A642D 663 12/52 .