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HomeMy Public PortalAbout4924 ROBINHOOD AVE_Sewer__ APPLICATION FOR PERMIT ' DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County- Engineer County of Los Angeles BUILDING { �+ JOHN A. LAh BIE, COUNTY ENGINEER _ADDRESS 7 CASSAT'T D.GRIFFIN, SUP'T OF BUILDING LOCALITY e, f � ®NEAREST FOR .APPLICANT TO FILL. IN CROSS ST. LEGAL DESCRIPTION LOT NO ✓'. OWNER MAIL BLOCK _--.-TRACT' ,r- .s'�y _ADDRESS NO. OF BLDGSe Y S(YX OF LOT NOW ONL JT CITY fes, ) TEL. N -- - - USOF BulI.PINGS ',�.,°>'i DISTRICT NO.. GROUP I MAP PG CONTRACTOR l� °yr`,,� a"'� - _ ��• a'�`� '' -"v' ADDRESS -? � µ�� �`�:. � --- � CONNECTION DATA _. STATION , DPrH CITY a p—� MANHOLE RE EF RENCE �"j �uPPER �STATE '''�•`+ �.._ �_. ��—.__,-- REGIS'1"RATION L<0, ,r } '`. :+ .� �i COUNTY -__---- -"'-- NO. DE'SCRIP'TION OF WORK --PEE - — v --- -- ----- � --TYPE OF CUNB-EC _IOLPLHOUSE SEWER CONNECTING TO Y. R- LENGTH. T . . PUBLIC SEWER -_-. -', SEPTIC TANK S-E-6AGE PIT 04 -- - i_ PITS AND/OR DRAIN Flr D 3.00 -- OVERFLOW SEEPAGE PIT, ©RAINFIFLD P. C. NO. ,. EXTN+. Cf55P00L,Dn71 aLL,MANHOLE !E y.?;pQ � CO.IMP. NO. ! JOB NO. � . HOUSE SEWER CONNECTING TO PPIVATV DISPOSPL SYSTEM tL C i,Q,Q �----� ]"RiJ-NK flERO. F�0.4D PERMIT N0. ---L- --- --- - --- --- -MIT '---- h9IT A+ --- ---..—_.--- COHNI:CT 0.0 rT10^�A' BLDG.F --- i STATE ENCROACHMENT WORK TO HOUSE: SEWER ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL I SEWER.OR DISPOSAL 5157E_17 C) � WASTE APPRO'JA.: t.- __._._�__}. CHARGES- ----:..-----_---------- ----._-.: CONNECTION CHARGE FEE. - OWNER'S PERIATIT _.-- - - --- -- REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE ` HAVE AT THIS RATS 0. CONTRACT W17K THE' HE'R..1I! NAME[) APPROVALS' L>.,.TE INSPECTLR'SSIGNATURE CON- _ _ TRACTOR TO CONNECT THE ABOVE DESCRIBED EXI: TING DWELUNG TO THE PUBLIC; SEW',ER. ) _ NEW HOUSE SEWER SIGNED THISDAY Cif 95__-- CO- - - - - - - -- — - �-� .NNLCT \DDi IONAL OWNER O.R BUIL'DIR K. OR WOR . �-- 9 OWNERS A6ENT�_:...„�,.-_ ._.. 6 ' � .�oftr' 0, ---- S -1"IC TANK,SEEP,PITIS1 I FEREBY ACKNO1,LEDGE THAT I HAVE READ THIS APPUATION rE O CC.frfPLY `'ESSPOOLLJI RYNEC:L ,4hD sl!'.. THAT THE nFJV.. i5 CORRECT AND �.(�:, _ _-- .____-- WITH ALL GG:iNTY ORDINA.ICES AND STATE LAWS REGULATiNG ALTER.REPAIR,SEWER OR PL'U.MRt. G AN SE`NE.RS. SEWAGE DISPOSAL SYSTEM I 1 PERcv1Y CERTIFY THAT 1 AM PROPERLY REGISTERED ANDi OR SC.ONNEGT PLUG AND LICENSE AS }UIRFt) BY LCIS AN:`ELES COUNTY AND NATE OF APANDON HOUSE SEWER ' CALIFORNIA OR -HAT I A-NJ THE LEGAL QW-NER OF THE ABOVE- --- •-- -- -------- ---_--- DF.SCRiRED qES)OrNTIAL F(OPER T SACK.FI L SEPTIC TANKS SF_EP. PiT(S) I� r•ESEP'OOLs Li i SIGNATURE _. ---_ _: .. ...� _-___.. ..-_ ..._._..- __-._.._.------ OF PERti(ITT .E' _- IOHN A. LAMBIE, tqdNTY ENGIN-EER VALIDATION ROBER'T A. W001), CtifEF PL.E'G. INSPECTOR M1 41) _.. ✓ ( .j