The URL can be used to link to this page

Home My Public Portal About5715 OAK AVE_Sewer_9/25/1956_0 S&E-6APPLICATION FOR PERMIT �EDMSION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County o County Engineer Y'..p. Y4WYMWWWI .. " m E Los Angeles BUILDING . ; WM. J. FOX, COUNTY ENGINEER ADDRESS d CASSATT O. GRIFFIN. SUP'T OF BUILDING LOCALITY C JL NEAREST FOR % APPLICANT VrF[�ILL�IjN �J CROSS ST. �r DESCRLEGIPTION LOT NO. /' / �'7 OWNER j//� �I _/aiJ / r - _ BLOCK TRACT MAIL ADDRES N0. OF BLOTS, / SIZE OF LOT _ NOW ON LOT L , - USE BUILDINGS p�� 1 CONTRACTOR/// n I/. 5 . iY/� ADDRESS %�� A+(,.4 CITY �n� � TEL. NO. .J /ssss�� STATE REGISTRATION NO. ��410- n NO. DESCRIPTION OF WORK FEE / HOUSE SEWER CONNECTING TO I`� PUBLIC SEWER © $ 3.50 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG. OR WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 SEPTIC TANK, SEEPAGE PIT OR _ PITS AND/OR DRAINFIELD 2.00 CESSPOOL- DRYWELL SPECIAL CONDITIONS ONLY 2.00 OWNERS PERMIT S I 1 00 AUTHORIZATION I TOTAL FEE 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER SIGNED THIS DAY 19— OWNER OR OWNERS AGENT ADDRr r I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE ICORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES S AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. I SIGNATURE OF PERMITTEE WILLIAM J. FOX, COUNTY ENGINEER BY BY CITY TEL. NO. 1 ., i01.;A.' Y. JIII6.YBuWMY114Y IwIYluYul 818a OI STRICT NO. GROUP BK MAP PG S Le �,3� CONNECTION DATA STATION�y( / 2 �1 DEPTH �. / aI RZ U MANUIILE REgEN CE O W1G1P ' 7�TL[( ILOWER f_ TYPE O ECTION /LENGTH FROM I Y. C URB% P. L. M.L. TO P.L. rSl CO. IMP. NO. JOB. NO TRUNK PERMIT N0, ROAD PERMIT NO. STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES CONNECTION CHARGE FEE REIMBURSEMENT FEE APPROVALS NEW HOUSE SEWER CONNECT ADDITIONAL BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) AND/OR DRAINFIELD CESSPOOL ❑ DRYWELL ❑ ALTER, REPAIR, SEWER OR SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND ABANDON HOUSE SEWER BACKFILL SEPTIC TANKS ❑ SEEP. PIT(S) 0 CESSPOOLS ❑ 4aI&97�t. { ``rr VALIDATIOg4 Ny n DEj.jC00 7 ) w. �� Ji:P 2 5 BY DEPUTY DATE JI INIPE//C��TOpR'S SIGNATURE v I� 1 4.50 fD DEPUTY �'` DEPUTY / § o ~r \§j ( \ \\ 2 § \ /R-3 //] -3 m / \ § f Pa : a }y ~c y To a = » e ® G \qƒ\(\\/ (%\\ \o ( \ / . . [ em = $ / x e-3 m/ rg g e »§kj In 31 8 °r (\ g m ) . . 13 \B § . R e 9 . \ /2 s / . ( § . rtj /