Loading...
HomeMy Public PortalAbout8615 ROCCUS LN_Sewer__ a L' Es(;. APPLICATION FOR PERMIT t$A$ 5F COUNTY OF CO ANGELES SEWER--SEWAGE DISPOSAL ?FPAR°fMEt�dT OF COUNTY ENGINEER �{ BUILDING AND SAFETY DIVISION BUILDING h.. JOHNA. LAIIEtE, Count{ Engineer ADDRESS f---- — -- WILLIAM A. JENSEN, Sup't of Bui?ding LocAL(Tv ( F FOR APPLICANT TO FILL IN cROss ST. > i_FCAd - -.� .4 J <- /" -_D FSCR 1 PT?ON L,07 NL OWNER MAIL BLOCK -._- TRACT r-1.f /F ___-_..__ -_ ADDRESS A � -w- 4q 1` S Y 1140. OF BLDG.Sd .. _-_ o _- SIZE O;� LOT NOW ON LOT CITY � �¢� TEL. NO. USE or DISTRICT NO. GROUP MAP PROCESSED 13Y su!tDINGs a CONTRACTOR �' ^= - _ _ +�7 ADDRESS � >' s l � CONNECTION DATA -�—-- G`IT},[ TELNO i STATION (! PT -_--r�" _,r- win-._may-�•. -ah i �� v1 ATE MANHOLE REFI RF NCE. )~ �'..---a `�.U R_ REGISTRAT(OEA NO. ,!',.F COUNTY `ntL NO. S GES(RIPTION OF rfb'.ORK FEE TYPE OF;;.0 QNECTION LENGTH FROM � -= HOLSE SEWER_O INEC tICaG Y. CURB P i, M L TO P.L. ePUBLIC'S EWER L $5 00 - _____ 11 — SEPTICTANK.SEEPAGE PIT OR -- -- t -_ --- � ? "� cl CO. IMP.NO. PITS ANDIOR.ORA ttJFtF,LD k____ ----. _ _____________ ___—__ -..:_ -___rte._— -_ G.� HOUSE SEW Eft CONNECC NG 70 TRUNK PERMIT NO, ROAD PERMIT NO. ac, PRIVATE DISPOSAL SYSTEM @ $3.00 -.. _—." I O ONNE,:T ADD IT 10NAL BLDG OR APFiLAV(T Y wnrvex erica Ex+T RECORD INSTR NO j DATE W RK TO HOUSE SEWER $3.4D0 OVERrLOW SEEP A GE.PIT,DRAINF'FLO I y -._._ L_ ,_..� U3 EX7N,C£SSPCG1t,DRYWELI_,MAN 'OLF_@ $F.00 Hwy.OR ST.WIDENING _._ ._ I ?L7 Eft.F r`AIR 4R ABAN UL?N r{OUSE I � SEWER OR DISPOSAL SYSTEM STATE ENCROACHMENT HERMIT NO. WASTE APPROVAL CHARGES LA OWNER'S PERMIT__ _ 'i z; Oo ------ ---.. ----------AUTHORIZATION Ii.�N TOTAL FE -`-_-_-._ t CONNECTION(CHARGE FEE REIMBURSEMENT FEE HAVE, AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- --------------- C.TOF TO CCINNECT THE ABOVE"_ DESCRIBED EXISTING DWELLING --- --�j-/�,yT---- ---- - ----- ------.-"-- ---- THE RUBL C EWER. , APPROVALS ALS DATE INSRECTOfi$SIGNATURE NECR YHiS _�- _C>P.Y 13! `. --------- OWN - - -----" __--- -- ER.,:i /. {"� ;� s "J� NEW HOUSE SEWER-____-____-.. ..R$ACENT_ �_?. J f"' ' CONNECT ADDITIONAL BUILDING OR WORKRESS SEPTICTANK.SEEP,PIT{S)_-HEREBY AC'K ,O'WLED_E THAT I HAVE READ THIS APPLICATION ANDYOR DRAINFIELO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLVH ALL COUNTY ORDINANCES AND STATE LAWS F.EGULATING -MBI.NG AND SEWERS.. CESSPOOL E] DRYWELLHEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR ALT€R REPAIR SEWER OR'NSE.D AS REQUIRED BY"ILOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM IF'.q R.NfA OR '1'HAT'1 AM T`!E Lk'.GAL GtitiNER OF, AND iNTEt•!DT'ODi5C0hN£C7 PLUG'ANDIL'E IN.. THE Fu3QY-DES.CR!BEC RESIUENTIAiy-PT�bPFRTY. ABANDON HOUSESEWER ATURE PE£?M IT7Ek..� BACKFILL SEPTIC TANKS [� } PI (S) I_] CESSPOOLS VALIDATION ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER / _r 6