HomeMy Public PortalAbout5249 SERENO DR_Sewer__ • DEPARTMOMJT OF COUNTY ]CMUNEM I� SEWER--SEWAGE DISPOSAL _ 1
DIVISION OF BUMDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENGINEER BUILDING
CASMA.TT M GRIFFIN SUPT or• Gui mm ADORE
S$
FOR APPLIC IT TO FILL IN LOCALITY
BUILOINB ,,nn NEAREST
ADDRESS /may_ CR0888T
LOCALITY DISTRICT NO
SERIAL nNO PERMIT NO
A., t A 102, 172,4 S
NEAREST
GROSS ST
/IRE,CE,IV/E�D BY IGAOY fw I�roAelloa DATE^ISSUED
OWNE I riT �� 1 - d l--SZ
MAIL
ADOREEIB .� USE ZONE 1 0n CUPANCY�////1)�� MAP
CITY TEL NO V___•Qf/V�'�U '
CONTRACTOR CHARGES BURBEMENTFEE
AODRESB 5 33 N �n� flIffED-
OT REQ
�/ T NOT REQ
GTY TEL IffO COMME N CN E FEE
J 0
REGISTRAT N NO COU NTY�d,fy�/ CO IMP NO 7
LEGAL RECEIPT MO DATE BY
DESCRIPTION LOT NO !
BLOC_Kft TRACT LI.L w WAIVER FOR RECORDING
O OF
SIZE OF LOT x I V I NOW ON LOTS RECEIPT-MO
USE OF
BUILDINGS
TRUNK PERMIT NO -�- _
NO DEBCRIFTWN OF WORK FEE
HOUSE SEWER CONNECTING TO ROAD PERMIT NOz /
PUBLICSEWER ® 0 860
HOUSE SEWER CONNECTINS TO STATE ENCROACHMENT-
PRIVATE DISPOSAL SYSTEM 100 PERMIT MO
CONNECT ADDITIONAL SLOG R INDUSTRIAL
WORK TO HOUSE SEWER 1 00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 100 CONNECTION DATA
AND
/OR DISPOSAL SYSTEMN SEWER 1001 STATION 2 �- ' DEPTH
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR GRAINFIELD 240 MANHOLE R EMCIE
CESSPOOL—DRYWELL UPPER Y+ /
SPECIAL CONDITIONS ONLY 1001 TYPE OF CONNECTION LENGTH FROM gjD
Y. _ CURB OYb M L TO P L 00
OWNERS PERMIT S I OD -
AUTHORIZATION TOTAL FEE vp Tl
COI HAVE THIS DATE COTRATED TRACTOR TO CONNECT THE ABOIyE TN DESCRIBEDTHEI EXIISTING ANED APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THEPU LIC $EWE
SIGNED THIS ��17DAY OF p'..ct _ 19 NEW HOUSE SEWER t7�
CONNECT ADDITIONAL
OWNS AGGENT _ .. y_ _ __ _ _ _ BUILDING OR WORK
SEPTIC TANK BEEP PIT(S)
AODRESS _ AMD/OR GRAINFIELD '
aHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E) DRYWELL E]
ION AMD STATE THAT THE ABOVE 18 CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
TERED
AND%OR LICENSED IAB REQUIRED BY FY THAT I AN PROPERLY
EANGE ESG BOUNTY
OIBCONNECT PLUG AND
ANO STATE OF CALIFORNIA OR THAT 1 AN THE LEGAL OWN , ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED REBID E IAL PROPERTY BACKFILL SEPTIC TANK I] 1
BEEP PIT(8)0 CESSPOOLS❑ 1
SIGNATURE
OF PERMITTEE _
76AWD 863 12/62 T