HomeMy Public PortalAbout9702 WOOLLEY ST_Sewer__ DEPARTDLENT OF COUNTY ENG]NEER SEWER--SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES —
WILLIAM J. FCX, COUNTY ENGINEER BUILDING
ADDRESS�7aZ jr�✓� L.d CeA ��j
FOR APPLICANT TO FILL IN LOCALITY 7 ,
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BUILDINGNEAREST
YCROSS ST.
ADDRESS / l 7 h
LOCALITY _y`'�-&'.-s•r.� ��
DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST /�+ T/� /T YC� �S F _ ---
CROSS ST. y(.! '— --- —
r RECEIVED BY Ready for Inspection �DA-TTEE-IISSUED OWNER A �'' 0 " J C, 4& ti "�' ,_
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ADDRESS terJ 4 t
CITY f s!, TEL.NO. � jv� -�n� �{ �
CONTRACTOR j� CO.IMP.N0.
ADDRESS ,IC . e ..3 JOB.NO. ,
i � �,, /�J� '
CITY ., TELAO. (1 TRUNK PERMIT NO.
STATE
REGISTRATION NO. 8 COUNTY ROAD PERMIT NO. --
LEGAL ��, STATE ENCROACHMENT
DESCRIPTION LOTNo. ®(} PERMIT NO.
BLOCK TRACT INDUSTRIAL - - ----
WASTE APPROVAL
SIZE OF LOT ]10 NOW ON LOTS CHARG
USE OFj
BUILDINGS �r � _ CONNECTION CHARGE F
NO.I DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
__ PUBLIC SEWER @ $ 3.50 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION'RECORDED
WORK TO HOUSE SEWER 1.00_
ALTER OR REPAIR EXISTING NO. DAIrE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER '
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
_ PITS AND/OR DRAINFIELD 2.00 STATION ,' DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOL REFERENCE
—I UP ER LOWER
TYPE OF CONNECTIOw LENGTH FROM
Y. CURB I P.L. M.L.TO P.L.
OWNERS PERMIT ; I I 00
AUTHORIZATION TOTAL FEE - I �--� -
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS...... DAY OF.. NEW HOUSE SEWER
OWNER OR
OWNERS AGENT.... CONNECT ADDITIONAL
BUILDING OR WORK
SEPTIC TANK,SEEP.PITS)
ADDRESS............... - ...-.........._......_.....................................-.. AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL El DRYWELL I3
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 AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT ABANDON HOPLUG PLUGAND
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE SCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE / SEEP.PIT(S)o CESSPOOLS E]
OF PERMIT .. .... -.1;....16 ..��.. ' d' -za�� P�«
7AAra�A aea 7152 i'T 'E''
(:)i;PARTIITI�TT OF COUNTY ENGINEER SEWER--SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGET S
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS—
FO_ R APPLICANT_ TO FILL IN LOCALITY _
BUILDING /`�� e�" NEAREST
ADDRESS t L1L-rj (n. Li-trCROSS ST.
LOCALITY . DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A 7 —/ 7s
e CROSS S7.
RM El B Ready for Inspection DA
E ISSUED
OWNERMAIL
4w. ADDRESS ' t�J ��� USE ZONE" OCCUPANCY BK
MAP PG
W
CITY TELNO. rQU' / I '
CONTRACTOR { r per CO.IMP.NO.
ADDRESS G`i fwd �'� f �E' b,#v6 2 JOB.NO.
CITY TELAO. .r '7 TRUNK PERMIT NO. - ---
""
STATE
ViL REGISTRATION NO.. v
�J y 8 COUNTY ROAD PERMIT NO. _LEGAL
DESCRIIPTION I,+O Nw- 7 J " ''" STATE ENCROACHMENT
--- -- PERMIT NO.
BLOCK TRACT ., rr r INDUSTRIAL —
`NASTE APPROVAL
SIZE OF LOT ,. ;�ri j� NO.OF SLOGS. CHARGES
NOW ON LOT
USE OF
BUILDINGS CO-D[ =T.'ON-CHARGE FEE f_�#`'' s°�s✓
NO. DESCRIPTION OF WORK FEE /
HOUSE SEWER CONNECTING TO REIMBURSEMENT'FEE' —72 6 � +
PUBLIC SEWER_ @ $ 3.50 t RECEIPT NO. DATE I BY
e— HOUSE SEWER CONNECTING TO f
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
_ WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO. DATc
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
_SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 + _ MANHOLE REFERENCEUPPER _ LOWER
_ I TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ I 00 -----P:L M.L.TO P.L.
AUTHORIZATION I TOTAL FEEHAVE
CON RACTOIR TDO ATE CONNECT THE ABOVE DESCRIBED IEXISTING ED
APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER —
SIGNED THIS...._.....-._.....DAY OF.__._. __..__.—-----____......19-__.. NEW HOUSE SEWER
1—
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT------------------- - QUILDING 4R WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS---....................-_._----..........-......_..........................-.........._... AND/OR DRAINFIELD
1 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
1 HEREBY CERTIFY THAT I 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 RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)E] CESSPOOLS❑
OF PERMITTEE-..-.- i...... ...........
777777
7RA642A 60 7/.53 ',