Loading...
HomeMy Public PortalAbout5912 RENO AVE_Sewer__ 1 CE808 1 -57 APPLICATION. F®R PERMIT E808 1 Y COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engr�meea ADDRESS CASSAI D. GRIFFIN, Sup't of Build°sag LOCALITY FOR APPLICANT TO FILL IN NE©ss sr. LEGAL =-- -- DESCRIPTION LOT N0. OWNER BLOCK TRACT - _MAIL s� - r' = ADDRESS NO.OF BLDGS. SIZE OF LOT S^P NOW ON LOT CITY TEL.N0, USE OF BUILDINGS DISTRICT NO. GROUP _ MAP CONTRACTOR -- BK PG a� ADDRESS CONNECTION DATA CITY TEL.. NO. STATION DEPTH Q STATE MANHOLE REFERENCE UPPER REGISTRATION NO, ❑. COUNTY LOWER NO. 1 DESCRIPTION OF WORK FEE _ I HOUSE SEWER CONVECTING TO I PUBLIC SEWER $3.5v- SEPTIC .5vSEPTIC TANK,SEEPAGE PIT OR - TYPE OF CONNECTION LENGTH FROM PITS AND/OP.GRAIN;IrLD @ $3,00 Y. CURB P.L. M.L, P.I. OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,CESSPOOL,DRYWEI_L,MANHOLE $2.00 HOUSE SEWER CONNECTING TO _ _PRIVATE DISPOSAL SYSTEM {a $1.00 C0jMP.NO, h'sI CONNECT ADDITIONAL BLDG.OR i-I -- WORK TO HOUSE SEWER ( $1.00 TRUNK PERMIT NO. aObD PERMIT N0. ALTER.,REPAIR OR ABANDON HOUSE - SEWER OR D15PO5Ai.SYSTEM @ $1.00 STATE ENCROACHMENT 6 PERMIT NO. - INDUSTRIAL , WASTE APPROVAL _ CHARGES _ OWNER'S PERMIT ! I 00 CONNECTION CHARGE FEE AUTHORIZATIONTOTAL FEE REIMBURSEMENT FEE. ` I HAVE AT THIS DATE.A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE jINSPECTOR'SS,iGNATURE TO THE PUBLIC, SEWER. 1-----�--- SIGNED THIS DAY OF _19 NEW HOUSE SEWER j OWNER OR CONNECT ADDITIONAL jIT OWNERS AGENT BUILDING OR WORK SEPTIC TANK.,SEEP,PIT(S) - ADDRE$S- --_--- --- ANO/OR DRAINFIELD - - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL] DRYWELL Cl _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. �ALTER,REPAIR,SEWER OR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEM LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT I AM THE LEGAL OWNER OF 'THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL P.ROPERTY., BACKFILL SEPTIC TANKS❑ � SIGNATURE _ SEEP. PIT(S) [I CESSPOOLS OF PERMITTEE 94 VALIDATION ROBERT A. WOOD CK. x.0. CASH SUPERVISING MECHANICA +L ENGINEER 27 p