HomeMy Public PortalAbout9659 WOODRUFF AVE_Sewer__ DEPAWfACE T OF COUNTY ENGINE= : SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY-OF LOS ANGELES I
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
fI ADDRESS G 4IS
LOCA4IT
FOR APPLI PJT�P I _ c
NEAREST
ADDRESS �,G�� CROSS ST. C,-"'j \�.0
LOCALITY DISTRICT NO. `SERIAL NO. -2
PERMIT NO.
t1
NEAREST -�� 1 1 II—� �C�G icn—S
CROSS ST. ECEIVED BY Ready for Inspection nn"DATE IIS1SUED
OWNER
MAIL ..USE Z69E OCCUPANCY BK MAP PG
ADDRESS
CITY THL.NO. .
CONTRACTOR /J CO.IMP.NO.
ADDRESS 661.
JOB NO.
CITY TEL.
NOX J:P)' TRUNK PERMIT NO.
J STATE:,
REGIS RATION O. t COUNTY. ROAD PERMIT NO.
DESCRIPTION LOT N0.`OZ,I c'�Oif, ` STATE ENCROACHMENT'LEGAL _.
PERMIT NO.
BLOCK TRACT INDUSTRIAL .
1 WASTE APPROVAL
SIZE OF LOT G(�) LCo
NO-OF NOW ON LOTS CHARGES
USE OFBUILDINGSCONNEC CHAROE'FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER "s $ S.50 RECEIPT NO. E BY
HOUSE SEWER CONNECTING•TO-
PRIVATEDISPOSAL SYSTEM- 1.00
CONNECT ADDITIONAL BLDG.OR �i, EXCEPTION RECORDED
"WORK TO HOUSE SEWER" IAO NO. I DATE I BY
ALTER OR REPAIR EXISTING ('
SEWER OR DISPOSAL SYSTEM 1.00 ��-
DISCONNECT AND ABANDON SEWER `?'
CONNECTION-DATA
DATA
AND/OR DISPOSAL SYSTEM I:00
SEP IC TANK,SEEPAGE PIT OR 1'
PITS AND/ORD.RAINFIELD 2.00 STATIONDEPTH
CESSPOOL—O RYW E LL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER OWER
TSE OF CONNECTION LENGTH FROM
OWNERS PERMIT ; I 7—00'- ` 'CURB P.L. M.L.TO P.L.
AUTHORIZATION I TOTAL FEE 06......
O, '
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED''
CONTRACTOR TO CONNECT THE.ABOVE VSORIBJD EXISTING APPROVALS INSPECTOR'S.SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER J�
7r'
SIGNED THIS .._D _AY OR __._. 9._ .. NEW HOUSE SEWER
OWNER
•-_ -.:..-- -.. .-.:_.._. ILNRAL
OWNERS AGENT.. BUDIGORWOKtet. fl rraGs
SEPTIC TANK,SEEP.
AND/OR E `T �C
ADDRESS..
I HEREBY ACKNOWLEDGE THAT-I HAVE READ THIS APPLI- CESSPOOL DRYWELL
CATION,AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL-COUNTY ORDINANCES AND STATE-LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. " SEWAGE DISPOSAL SYSTEM s '
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS-REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN
ER OF THE ABOVE DESCRIBED RESIDE TIA PROPETY. ! BACKFILL SEPTIC TANKS
SIGNATURE i '`'. SEEP.PIT(S)[] CESSPOOLS
OF PERMITTEES ._
70AG42A 669 7/53V I• l _
.~--7kDEPARTMENT T OF Coul*= ENG uq=R-'- SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY :. PERMIT APPLICATION `
COUI*= OF LOS "G}ETZS
BUILDING
WILLIAM J. FOX, COUNTY ENGINEER I ADDRESS �' DC-��i � 7 .
FOR_APPLICANT TO FILL IN LOCALITY
ADDRESBUILDINS E' s NEAREST
CROSS ST.
LOCALITY" `v (/� DISTRICT NO: SERIAL NO. PERMIT NO. c
NEAREST +• 1 S
CROSS ST. ^ RECEIVE Ready tot Inspection D '1•E ISS D
OWNER
MAILGS ZO OCCUPANCYm�CP
ADDRESS r ���jt.�{.3 tiS c' �x BK PG
/
CITY t � TEL.NO ^'✓�G °�' � �, � l'a
CONTRACTOR CO.IMP.NO.
ADDRESS q� r��s� 4G -a-,xq JOB NO.
CITY 77-17-1 1f:�$4,; ,+�yTEV4Oy/ ;7 TRUNK PERMIT NO.
REGISTRATION NO r ���sJ �� ® COUNTY ROAD PERMIT NO.
DESC RIP LOT NO. �S + ZEGAL STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT rf�` INDUSTRIAL
WASTE APPROVAL
NO OF BLDGS.
SIZE OF LOT �C7�7 NOW ON LOT CHARGES
USE OF
BUILDINGS CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLIOSEWER @ $ 3.60 RECEIPT NO. I TE I BY
HOUSE SEWER CONNECTING TO .
PRIVATE DISPOSAL SYSTEM- 1.00
CONNECT ADDITIONAL BLDG.OR ' EXGfPTION R OHOED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO IDATI\ I BY
SEWER OR DISPOSAL SYSTEM LGII
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAI NFIEL D 2.00 STATION �� �� Q DEPTH
CESSPOOL—O RYW ELL
SPECIAL CONDITIONS ONLY 2.00 // 1MANHOL_E REFERENCE LOWE
TYPE OF C CTION�. LENGTH.FROM
'OWNERS PERMIT ; I 00 B M.L.TO P.L.
AUTHORIZATION I TOTAL FEE -
1 D
HAVE THIS DATE CONTRACTED WITH THE HEREIN NAME
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING, APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS.-._�C�2,.DAY OF_ -�rlr _...19.�'. NEW HOUSE SEWER p 2
OWNER OR 7 / �/� CONNECT ADDITIONAL ff �..r a
OWNERS AGENT !Y..l�_:/._.. f-----------^ BUILDING OR WORK �GNIVAP v ��r C1
ADDRESS. .11. _. 1�.I! 1,.._ !`�1�?-Sant.. SEPTIC TANK,SEEP.PIT(S)
��. - AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI1 CESSPOOL DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS.' ALTER,REPAIR.SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUG AND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN••
ER OF THE ABOVE DESCRIBED RESIDENTIAL,�ROPERTY. BACKFILL SEPTIC TANKS EI
f
SINATURE SEEP.PIT(S)Ej CESSPOOLS 8- e
G
OF PERMITTEE..
-*, .` ._1 i0._-; �1 .�+.-'-0--
M642A 663 7/63 �,