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Home My Public Portal About6315 PRIMROSE AVE_Sewer__ APPLICATION FOR PERMIT f�'= COUNTY OF LOS ANGELES SEWER—SEWAGE DISPCaSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FA DING ADDRESS v p a 9 f y JOHN A. LAMBIE. County Engineer ='--__-- WILLIAM A. IENSEic Sup'E of Building r . LOCALITY RF� -E-CRJPTION OR. APPLICANT TO FILL INLEOIAL 55 5T. 1, --' --_— --- -- -- - - - - - r _- -- -- - DESCRIPTION iOT NO. --- OWNER ��k ��a. . �� MA1 L v .. TRACT ! ,� S'..tV-y ADDRESS __.__. —NO. OF SLOGS- F L.OT NOW ON LOT CITY TEI.., NO. NGSDI5'TRic:f NCr. G1-I C`Jt-1C"1'O.Rs9 ' TECONNECTION DATA.�{gp.�> vSTATION D77.1, 4 ,.- 7ATEMANHO_L REFERENCERATION h0k �° COUNYY 'TDES EWER ON EC WORK FEE $5.00 -- -----C kf _ _ _ TYPE OF CONNECTION LENGTH FROM - I HOUSE SEWER CONNECTING TO 7 p i Y CUR© - PA- W.L. O P 4f 1 PUBLIC SEWER C P..C.NO. J .�.yl' &EF vc' rANK..SEEPAGE F'iT OR ._ ----. 1 P{75 AN /OR DRAINFIELD $10.00 CO. IMP. NO. O .` HOUSE SEWER CO'SN 1 NG To TRUNK_. . _. — _ _ - - - )pPERMIT INO. DISPOSAL SYSTEM S 8: 0 {y __-fPR JATE - —___ --TLDOR R, 0IN^Fh?JNNE:T ADD!-,IONAL BWNY DATE. WORK'YO HOUSE SEWER ` $3.00 OVCR�.LOW SEEPAGE PIT-DRAINh IELQ FXTN.,CESSPOOL.,DRYWELL,MANHOL_E @ $5.00 _ HWY.OR S7.WIDENING _.—_. i. ALTER.REPAIR OR ABANDON HOUSE - '; SEWER OR CA E 'SPOSSYSTEM __.. — _ .___. STATE ENCROACHMENT' PERMIT NO. INDUSTRIAL WASTE APPROVAL .-_.-___.._____-__--__.____._ 2. 00.,_-. CHARGES OWNER'S PERMIT x' -- _ —- -- -- - - - - - . CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE 1 HAVE AT THIS DATE A CONTRACT WIT14 THE HEREIN NAMED PEON- RVIMBURSEMENT FEE TRACTOR TC CONNECT THE ABOVE DESCRIBED EXISTING DWE LAN --- ---- --- -- --*— --- --- --- TO 'THF: V".J 8L1 $EvYER APPROVALS DATE ] NSPEC TJR S iGNA7JRE SIGNED 'THI S---DAY OF_ _____1 OWNER OR I ' < NEW HOUSE SEWER 9WNERS AGENT_.__. �_ YCONNECT ADDITIONAL. ADDRESS BUILDING or WOR _ SEPTIC TANK SEEP,PITS) 1 HE REBY ACKNOWL.CDGE. THAT I HAVE HEAD THIS APPLtC.ATtON AND/OR DPAINFiELD AND >'.•..TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PL NIB ING AND SEWERS- CESSPOOL ,,;J DRYWELL HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND;`DR R ALTER,REPAIR.,SF WER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM LCALIFOR'N SIOE I 'A THE TF�rj'J AAM THE LEGAL OWNER OR OF, ,A:ND INTENQ TO QiSCONNECT PLUG AHDAB> � DESCRIBED RE!jirENTIAL PROPERTY. ABANDON HOUSF SEWER GNATUE9M?TTk F �'� f �. Sp BACKFILL SEPTIC TANKS I� _.y:z: - _ _.- ----_ SEEP_PITS) P CESSPOOLS VALIDATION ROBERT A. WOOD p SUPERVISING MECHANICAL ENGINEER CK '� M.O. GASH jf'