Loading...
HomeMy Public PortalAbout5656 SULTANA AVE_Sewer__ APPLICATION FOR PERMIT �« COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL U DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION SUILD I ro x' JOIN A. LAMBI£, County Engineer ADD RE ss (� r WILLIAM A. JE'NSEN, Supt c3 BuildingLOCALITY /��4•> yy NFAR_ T FOR APPLICANT JO FILL_I1V CROS -LEGA _\\.__--•.- f -1 J9_T ! '} d. --_ - DESr_RIF7I0lVI -W >-C7YrT5 CS ; ;,- J -.1- 1 OWNER MAIL .BLOCK TRAC'1 �,.. %y+-_.._✓mr.r ADC,RF$5 N L3. OF BLOCS. SIZE OF LOTNOW ON LOT CITY TEL. NO,. USE OF DISTRICT NO. GROLa Fx0CxSrY BUILDINGS MAn d- _. _ -- ACTORONr - ail_ot� ADDRESS yr` �/ . CONNECTION DATA -- �,✓> STATDEPTH ION -r .CITY "`' asp'3;J. .fly 6� TFi. N i 't". ATE MANHOLE REFERENCE _ r/ UPPER REGISTRATION NC. COU N7Y ND. DESCRIPTION ^F WORK FEE -- 7Yr O CONNECTIiSIN � LENGTH FROM - ¢ HOUSE c WER CO JN TING TO __. Y J� CURB P L. M.L O P.L. ✓ YuE I..SLVekR Ca, S-S-UO �.__. r/'1 ^_ -- -_—P C.NG - T___- k;. »7777 _ - - _.- ---+ 5 PT C TANK 5- iCE 2!T OR � � PITS a.NDi OR DRA 7�F;ELD SID.UD Co. IMF NO J06 NO - -- HOUSE SE WC:F r07v{ NG TO TRUNK PERMIT'NO. ROAD PERMIT RI/A-E u ,SAL Y E EM S --_ 1 GCORANSTR - .,y rONNECT ADDlliON-�BLDG.OR wA!Vc4� EASExchr WORK TO HOU E SEWER @ S3.00 - -__-_ _.. - GV_R"LOW SEEPAGE.FIT,DRAINFIELD EXTN„CE SFC)OL.DRYWELL,MANF40LE @ $5,00 s'm; _. .__ -- __..--_ HWY,OR ST.WIDENING A�TEF.,REPAIR OR ABANDON!#OUSE -” I SEWER OR DISPOSALYSTEM Q $3.00 ., . .-_._..___.. $3.00_ STATE STATE ENCROACHMENT . PERMIT NO. INDUSTR'IAI_ i WASTE APPROVAL CHARGES OWNERIT—- ----- --- z—;poa�-f ' —C-C—N N-EC-T-IO-N-CHARGE FeE ;giAUTHORIZATION[-mm-FiE ------- ---------------_--- REIMOURSEMENT FEE HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED COPd - TRACT?RTO CFiNEC_•T' THE A50VE DESCRIBED £X15TING DWELLING. .-__-___._-__g_p�-p.___y'._- __.___r. I _d _ TO THE PU5LtC SEWER. - APPROVALS DATE, N5PEC'02 5. .C;IAT; RE SIGNED THIS____a /AY QF `fY ..-i— ._-- / I 1 OWNER OR 4'71 NEW HOUSE`-.F-W£R - OWNERS AGENT___._�. CCrr -- --- --- -- CONNECT ADDITIONAL A Dii R F.-S__. SEPTIC TANK,SEEP PIT(S 1 8UI.LD NG OR W0RK I HEREACKNOWLEDGE THAT 1 NAVE. READ THIS APPLICATION AND,OR LIRAINFICLD 1 A.ND 5TP.TE 'THAT 'THE A80VF. iS CORRECT AND AGREE TO COMPLY .-.---.---- - -----WITH ALL COU(` Y ORDINANCES AND STATE LAWS RE:GULATil+LG � I PLU ME' ''CY AND SEWERS. ESSPOOL ORYWELL j LF HEREBY r E.jT IFY THAT I AM PROPERLY REGISII EKED AND/OR ALTER,REPAIR,SEWER OR i A REQUIRED YiY' LOS ANGLES COUNTY AND STATE OF 6EWAG DISPOSAL.SYSTEM RN fA OR THAT I AM THE LEGAL. OWNER OF, AND INTEND TO -___._. -_____- --.___-__{-. !N, THE A l+E DESCRISEO REG.SDENTIAL PROPERTY, ABANDON NC"T PL G AND D ABANDON HOUSE SEWER ,�- /URE 'w. �,� ��!/gERMI'uTE6. �° _^''� ,L __ ���i'I-- dBAGISFILL EPT: TANKS �- sEFP,PI,(5) CESSPOOLS ❑'� I VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER- CK. M.O.. CASH