Loading...
HomeMy Public PortalAbout6333 TRELAWNEY AVE_Sewer__ • f DEPARTNOENT OF COUNTY ICN(UaTI= SEWER=SEWAGE DISPOSAL 1 DIVISION OF HUMDING AND SAFETY PERMIT APPLICATION COUNTY OF L08 ANGELS _ WILLIAM J�ox._FCUNTY ENGINEER ADO.E188���3 '1 ?R APp11/�e/J,T T RLL IN IWASTE ALITY ADDRESS ) / REST BUILDING UIL IN ) J JID��..//��A_wTN_I�.LJREST LOCALITY T • TRICT NO RgET IAT IWFNUoo ^^ PERMIT NO C NEAREST S f O 3 o / S CROSS 8T VED DATE ISSU Y D TE OWNER MAILEZONE OCCUPANCY MAP ADDRESS BK PO CITY TR - / �7 - 3CONTRACTO 02,Nn MF NOL /2S _ADDREBS,LC�Z_g14 4A I/ _0� NO --TCITY�, Q', � �. <tTELMD.T m 1�� NK PERMIT NO 6REBIBTRATION NO 1,�/ � ['' � CD PERMIT NO LEGADESCRIPTIO 1 LOT NO ,Y4 K3E ENCROACHMENT y MIT MORDCR ' TRA" -L �� 15� STRIALTEAPPROVAL SIZE OF LOT NO OF BLDG& NOW ON LOT I CHARGES BUOF IE DINGS CONNECTION CHARGE FEE NO DESCRIPTION OF WORK FEE REIMBURSEMENT FEE /J HOUSE SEWER CONNECTING TO PUBUCBEWER M S SJNDATE BY HOUSE SEWER CONNECTING TO (J _ _S PRIVATE DISPOSAL SYSTEM IES _ CONNECTADDI IGT NAL BLDG 08 EXCEPTION RECORDED WORK TO HOUSE SEWER IDE _ ALTEROR irP�REXISTINS NO DATE BY SEWER OR DISPOSAL SYSTEM 100 _ DISCONNECT AMC ABANDON SEWER _ AND/oR DISPOSAL SYSTEM 100 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR _ PITS AMD/Ofl GRAINFIELD 2d8 STATION DEPTH Gj CESSPOOL-DRYWELL J SPECIAL CONDITIONS ONLY 200 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM V CURB P L ML TOP L OWNERS PERMIT i 1 Do AUTHORIZATION TOTAL FEE SD _ n I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED `y (/ CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SISN 'TURE .D TE DWELLING TO THE PUBLIC SEWER - / '` q SIGNED THIS DAY OF ( NEW HOUSE SEWER i ILLij>U�l�l/ - ,S OWNER ON CONNECT ADDITIONAL OWNER( AGEST 'P BUILDING Ofl WORK SEPTIC TANK SEEP.PIT(S) ADDR[SB AMD/OR GRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL DRYWELL� CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR.SEWER OR REGULATING PLUMBING AND BEWER6 SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND AND STATE OF CALIFORNIA OR THAT 1 AN THE LEGAL OWN- ABANDON HOUSE SEWER ER OF THE ABOVE QESCAIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TAkRI'T SIGNATURE 1 ' 1 BEEP PIT(8)[] CESSPOOLS0 I OF PERMITTER _ _ ` TOA6UID SQB 6W 6/66 I