HomeMy Public PortalAbout5720 OAK AVE_Sewer_9/8/1958_J8AE-66 APPLICATION FOR PERMIT
S & 6420 11.59
DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE
Deportment of County Engineer 1.. , , I I L
County of Los Angeles BU..E '% �J /d ry/
JOHN A. LAMBE, COUNTY ENGINEER ADDRESS //D.
ID CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY
'1dxln.unu..l uwollne,.�. ew�euu.nuul.uLel,li nu,Iwu,d.11medJln"1i°0In NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
LEGAL
DESCRIPTION
BLOCK
SIZE OF LOT
USE OF
BUILDINGS
CONTRACTOR
DISPOSAL 1
pu
41A6 .41c
T_x/rlPc ' G . Ty
LOT NO. JE I B Ji f I�. V2 ( / OWNER 4 vc? /Y t. %
MAIL
T1RAAC�T /� 4's- ADDRESS .% 77,p Ale,
ri
NOW ON
J'J III/.C. eLOT
;f(Al IIY � IU ITIS DISTRICT
NO �' _
i���a�dde.IlunlW GROUP ��Ji)�
NO OF BLDGS.
- �i/' DI$TRI MAP PG
BK
ADDRESS
//++`� O t r CONNECTION DATA
/'i /1/7 � �/[ // Z
CITY //ty� _p TEL. N0. ^(�.� L STATION DEPTH
% / 4r 6,fr ir- ! I • _ MANHOLE REFERENCE UPPER
j Qy��(/4� ��_X) STATE LOWER
REGISTRATION NO. / / V `� -3 O•.M�NTY
No. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO = TYPE OF CONNECTION LENGTH FROM
PUBLIC SEWER @ $ 3.50 Y' CURB P. L. M.L. TO P, L.
SEPTIC TANK, SEEPAGE PIT OR -
PITS AND/OR DRAINFIELD @ $ 3.00
OVERFLOW SEEPAGE PIT, DRAINFIELD
EXTN..CESSPOOL,DRYWELL,MANHO LE @ $ 2.00 ° CO. IMP. N0.
HOUSE SEWER CONNECTING TO '$
PRIVATE DISPOSAL SYSTEM @ $ 1.00 j� TRUNK PERMIT NO.
CONNECT ADDITIONAL BLDG. OR STATE ENCROACHMENT
WORK TO HOUSE SEWER @ $ 1.00 PERMIT NO.
ALTER, REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ 8 1.00 . WASTE APPROVAL
CONNECTION CHARGE FEE
OWNERS PERMIT S 11 00 °
AUTHORIZATION I TOTAL FEE 7 I R0 REIMBURSEMENT FEE
1 HAVE AT THIS DATE CONTRACT WIT HE HEER�EIN NAMED c6N-y_ APPROVALS
TRACTOR TO CONN TH - VE IBED FJCISTING DW ELLIN
TO THE PUBLIC SF)L 'f NEW HOUSE SEWER
SIGNED THIS GAY 1 1W JI CONNECT ADDITIONAL
OWNER OR f- -�y�N BUILDING OR WORK
OWNERS AGENT SEPTIC TANK, SEEP, PITS)
ADDRESS = ANO/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION _ CESSPOOL❑ DRYWELLE)
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY =
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - ALTER, REPAIR, SEWER OR
PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT 1 AM PRO L f
LICENSED AS REQUIRED BY LOS ANyt{MES U
CALIFORNIA CA~T 1 A 7HE A MIN
OF PERM
.11, 1,1'
u1
JOHN A. k
P. C. NO.
JOB NO.
_ROAD PERMIT NO.
CHARGES
DATE INSPECTOR'S SIGNATURE
= SEWAGE DISPOSAL SYSTEM
AND/OR _ DISCONNECT PLUG pND
STATE OF _ ABANDON HOUSE SEBACKWER
E ABOVE -
SEEP. IT SEPTIC TANKS ❑
SEEP. PITS) ❑ CESSPOOLS 0
ALIDATION ROBERT A. WOOD. CHIEF IPI -8G. INSPECTOR
4 5 6 8--�ASSEP 81 A 2.0 0 m
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