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HomeMy Public PortalAbout5829 PRIMROSE AVE_Sewer__ 7eA690APPLICATION FOR PERMIT ` DIVISION OF BUILDING AND SAFETY SEWER•-ffi I SPOSAL Department of County Engineer - County of Lae Angeles BUILDING ,. � r- —ADDRESS - .,C7,-Ci 1 A. 9�r'�iJl�lr=, �.`.t��:i�:TY EI<ivI&�tEER J CASSATT D. GRIFFIN, Su:. r or Su Lrmre c LOCAL;T"i FOR APPLICANT TO FILL I CROSS NEARESst. LEGAL - - -- DE cRIPCIGfV LOT'NO, - OWN e�f' ADDRESS Bi..©C.K ------ MAIL m SI-%E or LOT NOW ON LOT � CITY. w TEL. N0r , : USFC Lr�IIN�S DISTRICT NOf 'i. GROUP MAP YI i - - . — — - BK P .,ON'FKV ICP r, CONNECTION DATA _ i STATION DEPTH _ -- —— — -- — CITY_ _ire. h0_, MANHOLE REFERENCE RE ISTRr TtCN NO, J UN Ty J CIt>. DESCP PT'ION OF'A,10I�K eE _ __1 _-- __ - .. . __.--- ---.. _- TYPE OF CONNECTION LENGTH FROM HOUSE StMl. i. lV.rr,.CrTNG i0 Y. CURB I.L, h-.L.TO P<L, PUBLIC SEWER {� S 3,50 I _._ ._.._—__._.�. ._-— _—._ S �C":T4P I{ SEEPAGE PIT OR I PI , ANL`lo?a DRAINS' I1 �r' sa.(aF1 i. OVERF!OW SEEF',AC PIT Jk� Nt t':Lp - P C N'0, - E.3TN ,CESS POOL,DRYV,1 rL-1,MAN tOIE [ e 2.GID 9 CC7. IlIiP, NO jOB NO, 14CUSE SE ER r ONNCCTFNG To { .i P tF7E D7SPOSAL r rE fi n F,t ril SPUNK PERMIT NO. ROAD PERMIT NO, OiiSr C'7 ADDITIONAL ry, G.OR .�;; STATE ENCROACrItPEV" - r} , 'iC OUr S ,r.2 r ;� PERfd;T.NO. ^r ; R,REE 11 0 �,DON f USI:.. 0 ul - t�3r l '/5e.y' c INDUSTRIAL WASTE APPROVAL CHARGES C0:{NEGTI(Jiti.CHARGE FEE OWNERSOrl AUTHORIZATION PTEO�TA FES f � REIMBURSEMENT FSG' -- - 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS 'i DAIF. IINSrE.CTOR S.SIGN,AiUPE RACOR I'J TO 'i_iC.ONNECT THE ABOVE DESCRISED EXISTING_D�/BELLING - Put3!I>r SEWER. NEW HOUSE SEV,'E? SIGNED THIS —...---OA' `vF.,_ _ 1S^d_ CONNECT _ADDITIONAL OWNEP OR _3-' r F3WLDfNG OR WORK ---- —'--- --- --I— --'— - DINNERS AGENT _ __-.,._..."_. SEPTfC TANK,SEEP,PIT(SI AND/OR DRAIX ;ELD HEREBY ACKNOWLEDGE THAT I HAVE: READ THIS ADPL CAt'ION �� AND STATE THAT THE ABOVE CCSSP�OL U 'DRYWELL_'L1 � CORRECT AGREE ALTER,REPAIR,SEWER.CN C(?RhLCT AND A..REE T't3 COMPLY 1r?"[i ALL, :":�7JfV tY ORDINANCES AND STATE �.AYJS REGULATING i . . PLUMBING AND SEVIE„S, SLVVAGn DISPOSAL SYSTEM 1 HEREBY CERTIFY t 4Y 1 Aryl PROPERLY REGISTERED ANO OR ---'- --- --- - _._. _ t,ICENSIED A'a REQUIRED SY LOS ANGELES CGUN-"I'Y AND STATE OF DTSCOXXN CT PLUG ANI) i CALI1 ORNJA OR THAI ! AM THE L. GAL OWN;BR OF IHE'. ABOVE ABANDON HOUSE SEVxE'R DESCRIBED RESIDENIIAL I R,vPER'I-Y, BACKF1L1 SEPTTANKS C . , SEEP.PIC( CESSPOO:LSSIGNATURE ----._ I ROB PT A.WOOD, CHIEF P.L—EG. I_a._..P--EC--TO RLI �hiA. &vt . (ouh,Y ENGINEER � Cx _ IL 9 cASR tm "r; 4 A 3-0