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HomeMy Public PortalAbout5333 WELLAND AVE_Sewer__ 766t�.6 C363 P1�5� & APPLICATION FOR PERMIT 3 .6 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL. Department of County Engineer County of Los Angeles BUILDING �y y� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESSWelland �Tell StroeY .P7 CASSA'TT D.GRIFFIN, Sul',.1 BUILDING LOCALITY T_._aple Olt - FOR APPLICANT TO FILL IN _cEAE s sr. u� LEGAL _ DESCRIPTION LOOWNER NO. �:. q.:; iff$tforL . BLOCK TRACT MAIL ay y - , _ -ADDRESS Gg_. S' 1. d- Street - S12I OF LOT_ NOW tiONBLOTSCITY em ie Cit TEL. i`o.GI-5900 U5£OF�— ----- - - -UILAdNGS DISTRICT NO. GROUP MAP B BK PG CONTRACTOR - ) ! 310 X. Huntington D'� CONNECTION DATA ADDRESS ------ – - - -- — — _ y�_ yip gay�j,,�, � _ CITY Oad!a TEL. NO. HI-791 _STATION ___ _-_._ DEPTH _-_- --- MANHOLE REFERENCE __UPPER STATE :STRATION NO COUNTY _---�— REGI ,�. NO. i DESCRIP11ON OF WORK FEE _� 4 _-....--- 'TYPE F CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO f-------- CURB P.L. M.L.TO P.L. PUBLIC SEWER ji --- —.— ._�---- ... SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINF ELD $3.00 T OVERFLOW 5EEPAI E PIT GRAINFIELD P' . - EXTN CESSPOOL.,DRYWELL,N NHOLE r 2.JDI I O. IMP. NO, JO 0. I40USE CONNECTING TO PRIVA r.DISPOSAL SYS'-_'A (2 S 1.00 TRUNK PERMIT NO `•.,, s"`�RCAA PERMIT NO. CONNECT ADDITIONAL BLDG WORK TO HOUSE SENE a I STATE ENCROACI+N[.EN.S ^� S Q0 . v PERMIT No. ALTER.REQ,-....�_.^Y- ,�*�.A-L3ty HOUSE SEWER [NDUSTAP. WASTE AFP VAL CONNECTION CHARGE;FEE - OWNER'S PERMIT .--.__---- -- -- SLI REIMBURSEMENT FEE. AUTHORIZATION TOTAL FEE I Ty �fALa7 t+ RATE IINSPECTOR'SSIC,NATURE I HAYS AT ;HIS RATE A CONTRACT WITH THE HEREIN NAMED CON APPR®Y_--.-- TRACTOR TO CONNECT THE ABOVE DESCRIBED' EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER + ! SIGNED THIS- .___.--DAY O __ I9--_- CONNECT ADDITIONAL OWNER OR bUIL.DIN G OR WORK OWNEP'S __..--.__._..._.— 5'CPTI C:TANK,SPEP. PIT l5) ! j Ail DHES V ANG/OP CRAINFIELp. 1 HFRE."�Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL IJ DRYWELL� t AND Ta7>; EHE„ THE ABOVE IS CORRECT AND AGREE TO COMPLY � A1.k ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR.SEWER OR PLUMBING ;aJU SE ERS. SEWAGE DISPOSAL SYSTEM - i h R ` CEP'IFY 'I: , I AM PROPERLY REGISTERED AND..OF, -- - - --- CISCONNECT PLUG AND ' L-CER :`.5 F54.ltREL E/ LOS ANGELES COUNTY 4.ND STATI- 0*` ABANDON HOUSE SEWER CALIFORNIA OR IIiAT t AN THF 1EGAd_ OvVNkR. Or 1'}{e ABOVE DESCRISED AESIDN i.;,. PROPERT Y. I Ac Kf ILL SGPT C TANKS SIGNATURE " . . +p_ .1.P. }, LI CESSPOOLS _d __ __ — a PERMITTEE �•v ,=. _ st .�'°'` �.'u. I JOHN A. LAMBIE, COUNTY ENGINEER V.I LIDATIO�'l ;.tet. ROBERT A. WOOD, CHIEF PL.BG. INSPECTOR ..:;