HomeMy Public PortalAbout6360-6362 SULTANA AVE_Sewer__ 7CA13420
P-C63 11-5.5 APPLICATION FOR PERMIT
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles SUILDING 6360 & 611- Sultana �';.ve.
JOHN A. LAMBIE, COUNTY ENGINEER –ADDRESS 63/
S
CASSAT'"f'O. GRIFFIN, SUP T OF BUILDINU -OCALITY an C-,abriel
"0
FOR APPLICANT TO FILL IN
CR6SS ST.
'0
LEGA L
CRIP.ION! L T NO, OWNER ER Billingslea B. I son
2
BLOCK TRACT 6�3�6 2 `_�altan._, Ave.
ADDRESS
-3 x 2 21 NO. OF BLDGS. plus gara. CITY San C�abrie�tL, NO. AT 08
NOW ON LOT 7-L108
USE OF
S2 ldwelliim�s DISTRICT No. GROUP MAP
ULWNGSI
BK PC
CONTRACTOR
ADDRESS -:i
STATION DEPTH
cl ly TEL NO j-1,
MANHOLE REFERENCE
STATE
REGISTRATION NO _n COUNTY
DESCMMION OF ftRK FEE
TYPE OF CONNECTION LENGTH FROM
HOUSES WER CONNECTING To Y. CURB L. M.L.. TO L.
PUBLIC ii�WER @
_LSEPT X TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD @ s 3.00
1 OVERFLOW SF-`PAGE PCT DRAINFIELDP. CNO.
E XTN.jCESSPOQL,DRYWELL,I4AN HOLE a1 $2,C0 IMP.
NO JOB NO.
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM $
TRUNK PERMIT NO. ROAD PERMIT NO.
J CONNECT ADDITIONAL BLDG. OR STATE ENCROACHMENT
, WH
ORK TO OUSE SEN
' ER (7) $1.00 4L PERMIT No.
ALTER, PAi R ORA INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT $ 1 00
AUTHORIZATION TOTAL-FEE REIMBURSEMENT FEE,
I HAVE AT THIS DATE, A CONTRACT WITH THE HEREIN NAMED CON-
APPROVALS DATE INSP
ICTOR"SSIoNATORE
I
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUSL[C SEWEt. NEW HOUSE SEWER
SIGNED THIS OF
F__ CONNECT ADDITIONAL
OWNER OR UILDING OR WORK
OWNERS AGE14
SEPTIC TANK,S-EP,PIT(S)
ADDRESS—
n1 _iNDiOR DRAI ELrd
'0 1 -111
1 HEREBY ACKN(,)WLFDCE THAT I HAVE qEAD T141APPLICATION
0 CESSPOOL[I DRYWELL
T
AND STATE THAT THE ABOVE Is CORRECT AND AGREE ' COY.-PLY --------
WITH ALL COi%TY ORDINANCES AND STATE L AVV S R
PLUMBING AND' SEWERS, EGULAT!NG ALTER,REPAIR,SEWER OR i.
SEWAGE DISPOSAL SYSTEM
HEREBY CERTIFY THAT
I AM PROPERLY REG,!STERED ANC/OR DISCONNECT PL UG AND
LICENSED As REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA
OR THAT I Am THE LEGAL OWNER OF THE ABOVE --------
DESCRIBED RESIC"INNAL PROPERTY, BACKFILL SEPTIC TANKSD
SIGNATURE SEEP.PIT(S) Lf CESSPOOLS
OF PERM ITTE
JOHN A. LAMBIE,COUNTY ENGINEER VALIDATION-, ROBER'r A. W001), CIiIEF' PLBG. INSPECTOR
4 3 9 FEB 21 4 A 5.5