HomeMy Public PortalAbout5811 RENO AVE_Sewer__ 6A40E2 APPLICATION FOR PERMIT
COUNTYOF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT
T OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING �
T04N A. LAMBIE. County Engineer ADDRES
WILLIAM A. JENSEN. Sup't of Building
LOCALITY ter.
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. ;
LEGAL
DESCR YTiC?N .GT NO ..,�, a� C+'J L °' OJJNER is _ G �(.1 •'�- ---��_ { .id
_– – -- s
�+ •.,,,.. MAIL
SL6C:K "RACY .d' �L'"� ADDRESS
NO. OF SLOGS, -
SIZE: OF LOT NOW 0'J LOT CITY TEL. NO.
USE OF _
BUILDINGS - �° _ �' DISTRICT NO. GROUP MAP PR`?CESSED BY
- - BK PC
Oh7YR ACT'O � - - -
-_
AODREFis ,.Y'� ,�' ... CONNECTION
STATION ,{ j —------DEPTH +
TEL
LL�i s ATETYPE OK CONNECTION
.✓{ �_._
Re. I T'RATiON NO �.�y.. r'�' �,✓"'�Y COUNTY MANHOLE RE..LR"NG£' I p L.— �..'_ LOWER
NO� DESCRWORKP7iQN aOF WOK FES '�– ---- -- _ _L/
_-_ ...-._ -- LENGTH FRO - ..
f HOUSES W R CONNECIING O T ' � '_.i, Y C UIRSP-L.-- __— M.L.TO P L
5. "_
PUBLIC SEWER @ s00 `?. ! L --.. _— ,�_`�
ICT3
- – PIT TAND/ K. RAiNFIE.P3T OR !MP.NO j� .r �.% JOB NO.
PITS AND.OR DRA(NF)ELD �& ;iG,00 ,•
a.
PRIVATE AL SYSTEM @ 33 00
TRUNK PERMIT NO. TOAD PERMIT NO, � '��
WORKNCCI HDIDITi SEWER _ $3.00
.. _
HGI�SE S WER CONN E'_TI N(s O
OI SE
U S{O
C'�NNEC AGI ITidNA BLDG OR AF'F'IDAVIT�WAIVeR j. EASEMf NT 1 RECORD.1NS.TR.NO, DATE
S 3.00 j
OVERFLOW 5F'_PAGk Piz,DRAENFIELD
£1.TN,C`E 5S PO!?L"DRYWELL.MAP9HOLE 55.00
___ HWY.OR ST.WIDENING
ALTER.REPAIR OR ABANDON HOUSE
SE.WEF:OR CI`POSAL SYSTEM �. £3.00
—..__ ____ .-_ -----__ _ _.._.___ STATE ENCROACHMENT ,...
j PERMIT NO. -
----4--_....__..._._ INDUS-{RIAL
WASTE O:PPROVAL
.-. _. ` CHARGES
OWNER"S PERMIT z 9fl ----
._.._-,_. -. _ _.—_.__.—_— I -----CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE -- ----_ __.
I HAVE AT THfS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE
TRACTOR 70 CO' NEWT ..HE ABOVE DESCRIBED EXISTING DWEL.L(N( -- - - —
7C THE Pt,}BL f ..EWER. APPROVALS DATE I INSPECTOR'S SIGNATURE
SIGNED THIS
OWNER OR NEW HOUSE SEWER -
OWNERS AG ENT, �1Y--� - _..— CONNECT ADOiTI ONAL
--
ADDRE 5 BUi LD1 NC Oft WORK j
A EP7'I c,TANK.SEEP,P.7(5) ^
I HERESY A nt '�W'LED C THAT 1 h4AVC t'Ari 74+1. APPLICATION AND,OR D AINFIELD
AND 51 ATL: (F?AT THE ABOVE 15 CORRI.GT ANU AGREE TO GO MFL.Y
WITH ALL --COU PTY ORDINANCES AND STATE LAWS REGULATING
FLUMa NG AND SEWERS CESSPOOL L URYWELL L7,,
--I
1 1t_,2EBV .`Y TH. 7 I AM F'"ROPE 32EG1'Ii'E REb HNDI OR ALTER.REPAIR,SEWER OR. --------–
-�
L eNSED. EGiU IRE. H\' I_OS AN COUP7'1'Y AND 5'i'ATE OF' SEWAGE DISPOSAL SYSTEM
A�iFOR A TNA. AM THE: >,EGAL ER OF. AN INTEND TO --���—�--
C1 ANI NNf CT PLUG AN
D
B.:L� R% ID TIAL PRO TY. ABAN CON HOUSE SEV✓ R �
-{"�4'�+..,e.._. BA(,KF;I L SE PT iC TANKS
____- SEEP.N17(s) r] CEs5pOOLS �! — -----_
f
VALIDATION _,._ ROBERT A. WOOD
CK. M.O. -,`CA
-ASH%�� SUPERVISING MECHANICAL ENGINEER