HomeMy Public PortalAbout5056 SULTANA AVE_Sewer__ :egosOA64 ID-0a APPLICATION FOR PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE SPO!sAL
BUILDING AND SAFETY DIVISION BUILDING �5.
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A LAM M County Eagqm1Dew ADDRESS
WILLIAM A. JMEN, Sup I of Buddmq
LOCALITY
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FOR APPLICANT TO FML IN 0PO66 °T
DL4CRIPTION LOT NO OWNER
MAIL
BLOCK TRACT ADDflCfB
NO OF BLOGB
BILE OF LOT w NOW ON LOT CITY TEL NO r
USE OF DISTRICT NO GROUP MAP OCESSED
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ADDRESS CONNECTION DATA
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TEL STATION S DEPTH
STATE MANHOLE REFERENCE
REGISTRATION e COUNTY SOLA LOWER
NO CESC I N OF WORK ME TYPE o1 CONN[CTIO LENGTH FROM
MOUSE SEWER CONNECTING TO O Y CURB L M L TO P L � d
PUBLIC SEWER sew
SEPTIC TANK 4 EPAOL PIT OR P C NO O
PIT8.NO/OR DRAINFICLD f1000 CO INP NO Q JOS NO V
HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO K
PRIVATE DISPOSAL SYSTEM 3300 O
CONNECT ADDITIONAL BLDG OR AFFIDAVIT o11HI ",MNG RECORD INSTR NO DATE 0
WORK TO HOUSE HEWER C saw
OVERFLOW SEEPAGE PIT GRAINFIELD
LKTN CESSPOOL DRYWLLL MANHOLE Q SS 00 a
ALTER REPAIR OR ABANDON HWY GREY WIDENING
SEWER OR DISPOSAL SYSTEM O SB 00 STATE ENCROACHMENT
PERMIT NO
STRIAL
'`�T�p E APPROVAL
OWNERLS PERM fIt
CHARGES
AUILHORIZATION TOTAL FEE NECTION CNARO[F[tIHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMEBURSEMENT FEC
TRACTOR TO CONNECT THC ABOVE DESCRIBED FISTING DWDWwO�w*aTO THE PUBLIC SEWER L1MAll DAT[ INSPECTOR S.OIGHATURL
SIGNED THIS D�OWNER OR ��� CNEWONCONNECT ADDITIONAL OWNERS 6CNT CONNECT AOOITIOXAL
AOD BUILDING OR WORK
I X[R ACKXOWLLDDE T SEPTIC TANK SEEP PIT(S)
T I HAVE READ THIS .PPLICATION ANO/OR DRAI NFIELD
A.. ST TH THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND RATE LAWS REGULATING /
PLUMBING AND SEWERS CESSPOOL ❑ DRYWCLL ❑
I HEREBY CERTIFY TH I M Y REGISTER AND/OR ALTER REPAIR SEWEROR
LICENSED A6 REOUIRC 04 N6L[S OUNTY A STATE OF SEWAGE DISPOSAL SYSTEM
CALIRORNIA OR THAT L LEGAL OW R OF D INTEXD TO DISCONNECT PLUG ANO
REHIDE IN THE A D RIBED R p [NTIAL op.
ABANDON HOUSE 86W[R
IG NATURE ❑
OF FERMITT RACKFILLBEPTIC TANKS
6LEP PIT(S) ❑ CESSPOOLS
It ATIOROBERT A WOOD
CK -- M O A SUPERVISING MECHANICAL ENGINEER
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