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HomeMy Public PortalAbout9040 RANCHO REAL RD_Sewer_8/2/1954_30785S DEPART.BEENT OF COUNTY EN01NE s SgWER----SEWAGE DISPOSAL 1 DIVISI.ON OF BUILDING AND SAFETYPERMIT APPLICATIO_ N COUNTY OF LOS ANGELESUILDING - WILLIAM J. FOX, COUNTY ENGINEER I ADDRESS ��­el 2 rf P FORAPPLI ANT TO_FILL IN LOCALITY ADDRESS ®� O NEAREST CROSS ST. LOCALITY 1 L+mob .� DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST^ A CROSS REECCE�F-EDiv.LIX y Ready for Inspection /DAT ISS fD OWNER /(�� F1c�i `�C� MAIL ADDRESS / U,SPEEZZONE'®*' OCCUPANCY BK'MA PQ CITY ' TEL MO. .S�Q(2 I" CONTRACTORf , -3" 7 �® �/ Co.imp.N0. // . ADDRESS ! 6,�� �' /f �Sf S / JOB.N0. • J -- CITY +TTEL.M040 elle(1J O TRUNK PERMIT NO. REGISTRATION NO. ` J ��A y r/ ®:COUNTY.I ROAD PERMIT NO. 27452 LEGAL D STATE ENCROACHMENT a DESCRIPTION LOT N0. PERMIT NO. BLOCK TRACT INDUSTRIAL SIZE OF LOT 1 WASTE APPROVAL NT LOS `CHARGES NOW O USE OF " r I CONNECTION CHAII E BUILDINGS i NO. DESCRIPTION OF WOR _ FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO ! Iv TE I BY PUBLIC SEWER a $ 3.50 r RECEIPT NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 WORK CONNECT HOUSE ADDITIONAL SEWERLDG.OR 1.00 � , EXCEPTION RECORD ALTER OR REPAIR EXISTING / NO. I DATE BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2A0 STATION s ! DEPTH CESSP00 L—D RYW ELL SPECIAL CONDITIONS ONLY 2.00 S ANHOLE-REFERENCE UPPER— TYPE PPER- � L-0SYi;R� TYPE�OwtIQN.MRGTION LENGTH FROM / CU B - M:L.TO P.L. OWNERS PERMIT - S 00 AUTHORIZATION TOTAL FEE �f 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED, CONTRACTOR TO CONNECT THE ABOVE DE CRIBED EXISTING APPROVALS INSPECTO SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS _DAY OF Iq NEW HOUSE SEWER, ��P-,__ g �. y OWNER OR CONNECT ADDITIONAL OWNERS AGEN BUILDING OR WORK BU10017- ILDING TANK.SEEP.PIT(S) ADDRESS .�� AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE -61f CESSPOOL[] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR;SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM. PROPERLY REGISTED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTREY- DISCONNECT PLUG AND AND'STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-- ABANDON HOUSESEWER ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS 1 SIGNATURE - SEEP.PIT(S)11-CESSPOOLS:. OF PERMITTEE 7a ARA9A 992 7/6Z _ 111ZI-11 w 7 Esoa-a-88 C808•e APPLICATION FOR PERMIT 1 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer _ADDRESS — CASSATT D. GRIFFIN, Supt of Building LOCALITY NEAREST FOR APP CANT TO FILL IN CROSS ST. LEGAL — DESCRIPTION LOT NO. OWNER BLOCK TRACT MAIL - ADDRESS _ 1110.OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL.NO. USE OF BUILDINGS DISTRICT N0. GROUP MAP � PROCESSED BY BK P6 CONTRACTOR e n '�°id ADDRESS CONNECTION DATA CITY TEL. NO. STATION DEPTH STATE MANHOLE REF£RENC UPPER REGISTRATION NO. COUNTY LOWER ft y.:USE SEWER CONNECTING TO sr k'BLIC SEINER r� $3.00 ` SEPTIC TANK,SEEPAGE PIT OR TYPE UF CONNECTION LENGTH FROM PIT'S AND/OR DRAINFIF_LD @ $3.00 X. CURB P.L. M.L.TO P.L. OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,CESSPOOL„DRYWELL,MANHOLE @ $2.00 HOUSE, SEWER CONNECTING TO P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP.NO. JOB N0. CONNECT ADDITIONAL BLDG.OR WORK TO HOUSE SEWER @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. ALTER.REPAIR OR ABANDON HOUSE STATE ENCROACHMENT T BEWrR OR DISPOSAL SYSTEM @ $1.00 ” PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNmS PERMIT $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NA .FD CON, APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER, SIGNED THIS DAY OF-19— NEwi_HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP,PIT(S) _ ADDRESS -- _ -_ AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELLI7 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND DISCON LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCON N HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE — DESCRIBED RESIDENTIAL PROPERTY Y BACKFILL SEPTIC TANKS SIGNATURE .. SEEP. FITS) CI CESSPOOLS 13 OP'PERMITTEEZ v - ►• `-f"y' LID AATION ROBERT A.WOOD CIC:: .' Y.Q. CA6K SUPERVISING3 MECHANICAL ENGINEER } "'