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Home My Public Portal About4918 ARDEN DR_Sewer__ 3-64 76A642D APPLICATION FOR PERMIT 6A64 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING / JOHN A. LAMBIE, County Engineer ADDRESS r WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. OWNER _ MAIL BLOCK TRACT ADDRESS NO. OF BL GS. SIZE OF LOT NOW ON LOT CITY EL. NO. USE OF DISTRICT O. GROUP MAP PROCESSED BY BUILDINGS PG CONTRACTOR B� 5 I � ADDRESS COINNECTIO✓N DATA q CITY TEL. NO. STATION y DEPTHSTATE V REGISTRATION NO. COUNTY MANHOLE REFERENCE r �,L NO. DESCRIPTION OF WORK FEE TYPE OF CONN ION J LENGTH FROM? HOUSE SEWER CONNECTING TO Y. RB- P.L. M.L.TO P.L. PUBLIC SEWER @ S5.00 SEPTIC TANK,SEEPAGE PIT OR MPNOJ3 JOB NO. P.C.NO. } PITS AND/OR DRAINFIELD @ $10.00 CO.. . . ( a HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. O PRIVATE DISPOSAL SYSTEM Q 53.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD.INSTR.NO, DATE Ix WORK TO HOUSE SEWER @ $3.00 Q OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL,DRYWEL L,MANHOLE @ $S.00 V ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING IJJ 0- SEWER SEWER OR DISPOSAL SYSTEM @ S3.00 (� STATE ENCROACHMENT z PERMIT NO. _ V INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ 2 00 AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE A HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, TZEA �ESED S E'1T1 ROPERTY. ABANDON HOUSE SEWER L�01` NATURE BACKFILL SEPTIC TANKS ❑ PERMITT SEEP,P.T(Sl ❑ CESSPOOLS ❑,}��/�y VALIDATION--,., ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER LAGO4 6 5 2'coo MAY 2g 1 0 D 5.00- �' L CEBOB 12-88 A®®1 'C TIOIE9 F®® 4�i�11/CIT 76A 6420 r�r` e doh' f� d�" IYtl�, COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING /� �I ytl y` �� JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS C�vIL COLEMAN W. JENKINS. SUPT. OF BUILDING C LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS LEGAL DESCRIPTION LOT NO. OWNER ` MAIL BLOCK TRACT [ ADDRESS NO. OF BLDG&. EL. NO. SIZE OF LOT NOW ON LOT J USE OFDISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS r SK PGG CONTRACTOR / ADDRESSCONNECTION DATA CI XL. NO.-/ /- / STATION DEPTH STATE LICENSE NO. CLASS =� MANHOLE REFERENCE / �� LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENG7 FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.T P.L. PUBLIC SEWER $5.00 P.G.NO. SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD $10.00 CO.IMP.NO. JOB NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 53.00 TRUNK PERMIT NO. ROAD PERMIT NO. d CL CONNECT ADDITIONAL BLDG.GTr q� AFFIDAVIT w�IVEE E�5[M ENT RECORD.INSTR.NO. DATE CO .YWWPTO HOUSE SEWER @ $3.00 �J(/ OVERFLOW SEEPAGE PIT,DRAINFIELD CD EXTN..CESSPOOL.DRYWELL.MANHOLE $5.00 F__ ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING U SEWER OR DISPOSAL SYSTEM $3.00 1 t W STATE ENCROACHMENT I n- PERMIT NO. /!� GO Z INDUSTRIAL WASTE APPROVAL CHARGES OWNER$ PERMIT S 200 AUTHORIZATION TOTAL FEE !I CONNECTION CHARGE FEE 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO_CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. - APPROVALS D TE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR /I NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL BUILDING OR WORK ADDRESS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(S) AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ❑ PLUMBING AND SEWER . CESSPOOL ❑ DRYWELL I HEREBY CERTIF T I AM PROPERLY E ISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REO D BY LOS GLES C Y AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR AM T E Lf OWN OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN, T DES RIB ESIDEN PRQPERTY. ABANDON HOUSE SEW ER SIGNATUR iJJ/J BACKFILL SEPTIC TANKS ❑ OF PERMITTEE ❑ SEEP.PIT(S) ❑ CESSPOOLS VALIDATION_ JACK R. ALLEN CK. M.O. GASH�- (/�/�� SUPERVISING MECHANICAL ENGINEER A'fl, 9 4 6 0L I4AR31 1 0 0 5.0 0� Q 6&E6-6663 12.54 D APPLICATION FOR PERMIT 1 5 R E DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL � Department of County Engineer County of Los Angeles BUILDING WM. J. FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUP'T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS SL LEGAL _DESCRIPTION LOT NO. �.a OWNER BLOCK TRACT 1/ / "]� MAIL ADDRESS NO. OF BLDGS. / _ IZ SE OF LOT NOW_O_N_LOT CITY TEL. NO. USE OF BUILDINGS DISTRICT NO. ( GROUP MAP SK PG CONTRACTOR J fJ ADDRESS CONNECTION DATA c� CITY TEL. NO. - - STATION l�,, DEPTH , ❑ STATE / i MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY �.-J` /1+ "*3 P'FF'P. LOWER TYPENECTI ON LENGTH FROM N0. DESCRIPTION OF WORK FEE Y. CURB '7T. NLL. TO P.L. j HOUSE SEWER CONNECTING TO _PUBLIC SEWER $ 3.50_ — HOUSE SEWER CONNECTING TO ` PRIVATE DISPOSAL SYSTEM 1.00 __ a CONNECT ADDITIONAL BLDG. OR CO. IMP. NO. / JOB. NO. _ WORK TO HOUSE SEWER 1.00_ _ _- ALTER OR REPAIR EXISTING �� G SEWER OR DISPOSAL SYSTEM 1.00 I _ _TRUNK PERMIT NO. ROAD PERMIT NO. DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT _AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR -- --- PITS AND/OR DRAINFIELD 2.00 iNDUSTRIA.L — CESSPOOL- DRYWELL -- WASTE APPROVAL SPECIAL CONDITIONS ONLY 2.00 CHARGES 1 OWNER'S � PERMIT _S t 1_00 CONNECTION CHARGE FEE — AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVETRACTORT TO CONNECT THEDATEAABOVE DESCRIBED EXISTINGWITH THE HEREINA MED DWELLIING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP, PIT($) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL C] DRYWELL❑ 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. _SEWAGE_DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE SIGNATURE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS C1_ SEEP. PIT(S) ❑ CESSPOOLS[:I _ OF PERMITTEE WILLIAM J. FOX, COUNTY ENGINEER VALIDATION BY a,C1,0 1 8- MAR 2 4 4.5 0 DEPUTY -° DEPUTY BY BY DEPUTY '" DEPUTY c Z808 76A6 2D 63 APPLICATIZ�F�ROPE;;, 41T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Sup't of Building LOCALITY J NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL , 1 DESCRIPTION LOT NO. OWNER ��yy MAIL BLOCK TRACT '� j 415 ADDRESS O NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY NO. USE OF DISTRICT NO. OUP AP PR CESSED BY BUILDINGS % BK PG CONTRACTOR ADDRESS CONNECTION DATA �^^� STATION DEPTH B CITY l'^Y Elt NO. '' ElE) STATE /'s- v �� UPPER MANHOLE REFERENCE ` REGISTRAT N NO. COUNTY C OWER NO. DESCRIPTION OF WORK FEETYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $5.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR t- PITS AND/OR DRAINFIELD @ $10.00 CO.IMP. NO. .108 NO. O 0 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 104CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD.INSTR,NO. DATE O WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD al EXTN..CESSPOOL,DRYWELL,MANHOLE @ $5.00 ALTER,REPAIR O ABANDON HOUSE HWY. OR ST.WIDENING H SEWER OR DISPOSAL YSTEM @ $3.00 STATE ENCROACHMENT z a PERMIT NO. e [J INDUSTRIAL , WASTE APPROVAL CHARGES OWNERS PERMIT $ z 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE Cl '1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS_ BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(S) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ to I HEREBY CERTIFY THAT 1 M PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQU D BY S ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM 19 CALIFORNIA OR T A I A T E LEGAL OWNER OF, AND INTE TO DISCONNECT PLUG AND RESIDE IN, THE B VE CRIBEO ENT L ROPE RT Y. BANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTE_ SEEP,PITS) ❑ CESSPOO ❑ VALIDATIONRT A. WOOD G MECHANICAL ENGINEER M.O. CASH SUPE LAC;03 3 3 0% FEB28 1 0 0 5.00 a G��G�J