HomeMy Public PortalAbout6323 SALTER AVE_Sewer__ ,s^E-66 APPLICATION FOR PERMIT
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Deportment of County Engineer
County of Los Angeles BUILDING _7>
tOk- C N A. LAMBIE, COUNTY ENGINEER ADnREss -� � i -L,J
�- � �� =# A.
CASSATT 0. GRIFFIN, SUP'-,'OF BUILDING .;,LOCALITY -� -
Ng RES - —
FOR APPLICANT TO FII<IwwaI "_ CR S ST
LEGAL
DrSCR'PTION _LOT Nd. tirti —OW ER of
J TRACT 7' _ A AIL
BLOCK
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-.— -- — - N0, OF BLDGS= p CITY � TEL. NO,
ZE OF LOT as ,4 NOW G.N LOT S_
USE OF - r
BUILDINGS J DISTRICT NO. l GROUP MA
BN
CONTRACTOR
ADDRESS r i' _—�—�_w CONNECTION DATA
CITY ,�` TeL N0. f lr�, .° ,.. ;`� STATION_: ,_ nEPTH
d At'" xOLE Ri EP�REtVCE �. UPPER
—_ �..-..—..---�--- C! STATE ' ^. ° >/ fs _ LOWER
REGISTRATION NO. La COUNTY
No. ": DFS(PMMON OF WORK FEE - r
----- _.---. TYP _F COK'NECTION LENGTH FROM
P, USE S£WLR CONNECTING TO Y., CURB P.L. M,L,TO P.L.
I PUBLIC SEWER _ n_. $3.50 I _ ------ —-------M,
_..... .----_T -_.._ 5..3.00 .—i.._._--
` EPTIC TANK.,SEEPAGE PIT OR
i PITS ANO/OR DRAINFIELD _{''
OVERFLOW SEEPAGE PIT DRAINFILLD P. C. NO,
EXTN.;CLSSf 00_L,D�2Y vcLL,6 APS OLE 1 $.2 DO Cfl. IMP. x0,- -- — ;DB IVO. -- --
HOUSE SEWER CONNECTING TO j -�----
PRIVATC DISPOSAL SYSTEM In S1.00 DRUNK PERMIT NO. ROAD PERMIT NO.
CONNECT ADDI'!'',ONAL BLDG.CR "------ I STATC ENCROACHMENT
WORK TO TO HOUSE SEWER 6 $I,OU i PERMIT NO.
ALTER,P +,,....L.aJl HOUSE - i
SE WER S 'iF V (rx $1.0 a !v`rtSTE APPROVAL
l — --
._ _.. CHANGES
1.
---- ION CHARGE FEE -
OW ER'S PERMIT - -- - - — --- ----- - ------ ..___. —.—
AUTHORIZATION TOTAL FEE' i - � �� - —REI"r'.PURSEA?Exr FEE
. A CONTRACT WITH THE HEREIN NAMED. CON- APPROVALS DATE INSIECTCR'SSIGNATUiRE
1 HAVE AT THI DATE _.__ � -_--�
RAC OR To CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
J T r PUBLIC SEWER, NEW HORSE SEWER
SIGNED TH1S +"--_DAY O �3 � oJw �19 �e -- — -
-µ— 'ONNE'E,T ADDI[1CNA1<.
O'NNER OR - �..- BUILDING OR WORK
O'dr'Nf Rat�`.i k'.iV .i:.-..�._..,✓�'..q� °. -- C -_ "'"�...,:�..-"u-=�x,., SEPTIC TANK:,SEEP,PIT.IS1
AND/OR DRAINr ir1D.
hKRE3Y n-r N ALEDCE THAT 1 ",AVE READ r'NI APPLI TION I.... I
AND
STATE Ti. f THE ABCVE 15 CORr.�Cr AND ,�GdEE "f0 COMPL4` CESSPOOL DRYW£LL L! �
—t---— —
h I:H ALL CO i'NT'i ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
P:_UMB.',NG AND SE'NERS. SEWACE DISPOSAL SYSTEM j
1 HEREBY L i> !FY "'riAI 1 AM PROPERLY REGISTERED AND/OR
DiSCOPiN uT PLUG AND
LICENSED AS Rr.:U?RI:D BY LOS ANGELES COUNTY AND STATE OF I
CALIFORNIA OR THAT i AM TkE LEGAL OWNER OF THE ABOVE ABANDON HOUSE EWER
DESCRIBED RESIDENTIAL P'ROP,ERTY, 2ACXFILL SEPTIC TANKS L]
SIGNATURE i" @ SEEP. NT(S, ' F CESSPOOLS
OF PERMITTEE—
I �
JOHN A. LA.MBIE, COUNTY :: GIh3E:EF2 VAL1DATI -- ROBERT A. WOOD, CHIEF PLED. 1�sF Ec Gay
CM, h:.U. GA l e