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Home My Public Portal About10256 RANDWICK DR_Sewer__ 6A642_52 7 D -APPLICATION FOR.. PERMIT 6A842 COUNTY OF LOS ANGELES ;EWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FAD NG JOHN A. LAMBIE. County Engineer ! �{O.vVILLIAM A. JENSEN, Sup't of uifr IngFtss�yyy I7Y.Lerl:'.ii�„)„ CST["'! FOR APPLICANT TO FILL IN CROSS S�`li ckma Ave . LEGA[_ DESCRIPTION LOT NO.-_ _.__._._--_.__.__._.. OWNER MAIL BLOCKTRACT 27309 ADDRES _,"-.2t{6 TIy_9I NO. OFBLDC:. SIZE OF LOT NOW O7Y T -! Le _._.-.. USE OF BUILDING'u�'t.esi( ante DISTRICT NO. GROUP MAP - PROCESSED BY CONTRAC-",R, /x, .� ..- --- -.L vT3 ADDRESS CONNECTION DATA _ T /`t p: STATION .b / DEPTH T 47,7- ` t CI STATE 2 COUNTY MAN':H OLE RF'F ERLNCE R�GISTRA � R,F -- NO. )ESCRIpTfON OF RK FEE -.._ --- - ' . Y. TYPE OF C CNNE TIONP LENGTH FROM (OUSE SEWER CONNECT-N_.TO __ URFM. TOP.L. � 07PUBLSEWER @ $5: ------ �r -_- ND _ SEPT{C TANK iF EnAGE P!7 OR Y S AND -OR RAINFIF_LD -©_$70.00 co. IMP. NO, JOB NO 4.^ - HOUSE SEWER CONNECTING TO - �- ------- I- --- TRUNK PERMIT NO. ROAD PERMIT NO, PRIVATE DISPOSAL SYSTEM $3..00 C ON NECT ACOlT 10 NA [7LDG OR A FF:D WFT WM;"-1 EA5FMCMT 1T RE.CORE !N$TR NO. DATE WORK TO HOUSE SFWER $3.00 .._ - _OW OV,_R�'L5_EPAL r pl T,DRAIN'IELU i EXrN C.Eb SPOOL,DRYWEL L.MAM HOLE C $ QO _ _ _ HWY. OR ST,.WIDENING AL.TE R,i2ERAIR OR AIBANOON ROUSE- ----- �ScWER OR DSPOSA SYSTEM @ &3.00 . S _..A— M -- TA'E ENCROH -N7 - PERMIT NO. INDUSTRIAL f WASTE APPROVAL -...._- CHARGES OWNSW PERMIT -- z Oo --- - -- --- --- --- ---—-- --. - - -- -- AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT.FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EX;STING DWELLING --- - -_ --- -----r -- - - -.----- TO THE PUBLIC SEWER.. APPROVALS DATE �INSPECTOR'S SIGNATURE SIGNED THIS _ _ DAY OP - -- --- _: -._ _-_ S 9_. I OWNER OR NEW HOUSE SEWER OWNERS ''��yyJ� ------'----"—"- ----` CONNECT ADDITIONAL ADDRFSSBUILWNG OR WORK __- --- __. .'_ _. - SEPTIC TANK.SEEP.PIT(S) 7 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION i ANDS 9R DF AtNFI£LD AN1, SPATE T)-1..T THE. ABOVE IS OF?[3ECT 4WD .A:•,R..„ .O COMPLY WITH ALL COUNTY ORDITJA hiCES AND STATEN LAWS REGUI_AT'ING PLUMBING .AND 5EWER$ �j CESSPOOL E' DRYWELL CI I HEREBY CERTF!z'Y 7HAT:JI AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR Lt CENSER AS R L/IRED FtY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SY.STfM i CALIFORNIA THAT i AM THE LEGAL OWNER OF AND IN;rENO.TO D9SC ONfJECT PLUG AND �- RC5!DE N ABOVE DESCRIBED RESIDE Fq,L PROP RYY. ABANDON HOUSE.SEYJER 1 SIGNATURF;j` ,r KFILL SEPTIC TANKS OF PERM'ts.'#;CE _ t,, _.y _ �_. ., :'_L! _:Lt__ SEEP';pfT(5) CESSPOOLS TION ROBERT A. woOa GKS' M,o. rgsH SUPERVISING MECHANICAL ENGINEER