HomeMy Public PortalAbout5720 OAK AVE_Sewer_1/4/1954_DEPARTMENT OF COUNTY ENGINEER SEWER -SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
BUILDIWILLIAM J. FCX, COUNTY ENGINEER ADDRESS 5 n aB KIn, C)
�i.�-FOR APPLICANT T -
�tt,, ,O FILL IN LOCALITY
ADDRESS ..S OAA" Ae& CROSSST. II
- ADDRESS L.1 V P l J14.K.
DISTRICT NO. SERIAL NO. PERMIT NO.
LOCALITY PL ia- G , Y V CA I.. L P� -� p/ (� c
NEAREST 11 -t I A /7 < V/ S
CROSSST. L �#-4— i9aA RECEIVED BY ,yI ReedY for Inspection DATE'IS/SUED
OWNERG (I%`�l� / ./ ^ /
ADDRESS, { 2 6 n/yO Alf -A VA
�/ �J USE ZONE OCCUPANCY BK MAP
PB/
CITYrMpjG CI�'1 TELNO.AI k�qf
CONTRACTOR M.•C-4-nahaM AnrlN,-- CO. IMP. NO.
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ADDRESS 5933 N. CLnvvaiv ,,�� JOB. NO.
CITY TEMPLEEBIp, cA IF z THUNK PERMIT N0.
TE
REGISTRATION NO. ��/' 17.J ® COUNTY' _ dsc�
t ROAD PERMIT NO. rri�t
LEGAL
DESCRIPTION LOT N0. ,i I/ STATE ENCROACHMENT
;, /2 `JZ PERMIT NO.
BLOCK TRACT o J INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT Sn X X10 NOW ON LOTS I ` \ CHARGES
USE OF = CONNECTION C GE FEE
BUILDINGS
N0. H000 ESEWERCON NECCI N0 TORK FEE
I OE'= REIMBURSEMENT FEE
P UB LIC SEWER @ $ 3.50 L�_O, _ RECEIPT NO. I /D"T I BY
HOUSESEWE R CONNECTING TO \
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG. OR - /� EXCEPTION RECORDED \
WORK TO HOUSE SEWER 1.00 NO
ALTER OR REPAN EXISTING I DATE I BY �\
_ LTE 0OR DISPOSAL SYSTEM I.00
_ AN�DSPCT OSAL SYSTEMS SEWER L00 CONNECTION DATA
SEPTIC TANK, SEEPAGE PIT OR _
PITS AND/OR GRAINFIELD 2.00 _ STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 - -, q,? SI 5��„�,MABNOLE REFERENCE
_ TYPE OFACp�B ECTIONN LENGTH FROM
OWNERS PERMIT = 1 DD _ 6.1 M.L. TO P.L. 1�
AUTHORIZATION' TOTAL FEE I ;z J-6
CO
CONTRAHAVE CS DATE TOR TO CONNECT THTED WITH E ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER -
SIGNED THIS.—*__DAY OF + 19� . NEW HOUSESEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT..._.. .-.. - BUILDING OR WORK
�ry e -..._._._.._._. _.�
ADDRESSln.. y,...S�.Q....II.!ii rL .............. SEPTIC TANK. SEEP. PIT(S)
AND/OR GRAINFIELD
SEEP.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL C] 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUS AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN. ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDE.TIAL PROPERTY. BACKFILL SEPTIC TANKS _
_ SIGNATURE ;n G` Ce!-- SEEP.PIT(S)E] CESSPOOLS
- OEE..
7OA6
9y
FPERMITTEE_
663 7/53i
FOR DEPARTMENT USE
REQUIRED INFORMATION
1. INDICATE ALL BUILDINGS ON PROPERTY.
2. INDICATE AND DIMENSION SEWAGE DIS-
POSAL SYSTEM WITH TIE DISTANCES TO
BUILDINGS AND PROPERTY LINES.
3. INDICATE SIZE OF SEPTIC TANK—DEPTH
OF SEEPAGE PITS)—SIZE OF CESSPOOL(S)
4. INDICATE NORTH DIRECTION ON PLOT.
5. INDICATE BOTH STREETS IF CORNER. o (�
1D S- 1
LEGAL DESCRIPTION
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FIELD NOTES',Z�%-,54-5cAy;,2o - T STrd - COHi/.