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Home My Public Portal About4935 ARDEN DR_Sewer__ .62 76A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILD" JOHN A. LAMBIE, County Engineer AD- RESArdenI WILLIAM A. JENSEN, Supt of Building y LOCALITY `dem le Cit NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. ''tt o OWNER r. Townsen MAIL T1 BLOCK A TRACT 11148 ADDRESS 8700 00 Las Tunas NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY L. NO. USE OF -100+224 BUILDINGS DISTRICT NO. GROUP MAP PROCESSED BY es- /x' BK PG William CONTRACTOR Lia6'1 ADDRESS LL4L CONNECTION DATA ' CITY L. :1 J� TEL. NO. j, �6o�F60$ STATION DEPTH ❑ COUNTY El STATE MANHOLE REFERENCE REGISTRATION NO. _19()99 j� NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM �} HOUSE SEWER CONNECTING TO y�� Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $5.00 el{J P.C.NO. 0 { SEPTIC TANK,SEEPAGE PIT OR CO.IMP. NO. JOB NO. PITS AND/OR DRAINFIELD @ $10.00 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD.INSTR.NO. DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $5.00 ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT $ i 00 CHARGES AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE LRESIDE VE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING HE PUBLIC SEWER. APPROVALS o DATE 'INSPECTOR'S SIGNATURE ED THIS DAY OF 19_ ER OR �� NEW HOUSE SEWER _ ERS AGENT_ New CONNECT ADDITIONAL y BUILDING OR WORK RESS SEPTIC TANK.SEEP,PIT(S) EREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGBING AND SEWERS. CESSPOOL ❑ DRYWELL EREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR NSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM FORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND DE IN, THE AB V DESCRIBED RESIDE TIAL P O ERTY. ABANDON HOUSE SEWER ATUREBACKFILL SEPTIC TANKS PERMITTEE SEEP,PITS) ❑ CESSPOOLS ❑ VALII3ATI N ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.0. CASH -62 76A642D APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FA7 JOHN A. LAMBIE, County Engineer WILLIAM A. JENSEN, Sup't of Buildingem le CitFOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. 1 Q OWNER Mr- TOTAMqpn 1 4 MAIL 8700 Las Tunas BLOCK -) TRACT ADDRESS NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY t'tNO. USE OF BUILDINGS Res* DISTRICT NO. GROUP MAP PROCESSED BY BK PG CONTRACTOR S j DT. 1CM ADDRESS p 2315 E. 118 st •CONNECTION DATA LS CITY L. O 59 TEL. NO. LO-6-4608 ATION DEPTH ❑ STATE MANHOLE REFERENCE UPPER REGISTRATION NOFO. ElCOUNTY NO, DESCRIP WORK FEE TYPE OF CONN TI LENGTH FROM HOUSE SEWER CONNECTING TO Y. C P.L. M.L.70 P.L. PUBLIC SEWER @ $5.00 p.C.NO. A SEPTIC TANK,SEEPAGE PIT OR JOB NO. n PITS AND/OR DRAINFIELD @ $10.00 CO.IMP. NO. 8 HOUSE SEWER CONNECTING TO TRUNK PERMI NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 !JJ CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD.INSTR,NO. DATE WORK TO HOUSE SEWER @ $3.00 .� OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN.,CESSPOOL.DRYWELL,MAN FtOjE @ $5.00 ALTER.REPAIR OR ABANDON H HWY.OR ST.WIDENING SEWER OR DISPOSAL SY EM @ $3.00 STATE ENCROACHMENT r PERMIT NO. Yy 1 INDUSTRIAL WASTE APPROVAL CHARGES OWNER'SPERMIT $ AUTHORIZATION TOTAL FEE �� CONNECTION CHARGE F E IHAVE 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 ig_ OWNER OR NEW HOUSE SEWER �� • "' ,y'� OWNERS AGENT_ New CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK.SEEP.PIT(5) 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 [:1PLUMBING AND SEWERS. CESSPOOL ElDRYWELL IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS 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, THE ABOVE DESCRIBED RESIDENTIAL R ERTY. ABANDON HOUSE SEWER SIGNATURE OF PERM}TTE BACKFILL SEPTIC TANKS ❑ SEEP.PIT(S) ❑ CESSPOOLS ❑ VALIDATI ROBERT A. WOOD CK. M.O. SUPERVISING MECHANICAL ENGINEER CAS L,,vC D S&E-683 It•55 APPLICATION FOR PERMIT .0 1 S&E-6 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Deportment of County.Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 7 ® CASSATT D. GRIFFIN, SUP'TOF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS sr. �w i t.�L LEGAL OWNER DESCRIPTION LOT NO. MAIL BLOCK TRACT ADDRESS N0.OF BLDGS. CITY TEL. N0. SIZE OF LOT NOW ON LOT USE OF DISTRICT N GRO IP MAP BUILDINGS o ,d-_ i, I BK CONTRACTOR ADDREss � �- /� ONNECTION DATA CITY �/ TEL. N0. STATION PTH MANHOLE REFERENCE , ' UPP / STATE t LOWER REGISTRATION N0. � �(� 'p" C1 COUNTY NO. DESCRIPTION OF WORK FEE TYPE OFION LENGTH FROM HOUSE SEWER CONNECTING TO Y• P.L. M.L. TO P.L. PUBLIC SEWER @ „� Da SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT, DRAINFIELD CO. IMP. N0. 3 2 /. JOB N O EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT N0. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER ,@ $1.00 / PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIALJ SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROV / go CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ 00 REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE.A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER •�` _�.� Z-�� SIGNED THIS DAY OF. 19 CONNECT ADDITIONAL ° r OWNER OR r /�// BUILDING OR WORK T -, OWNERS AGEN /� f 1/✓1A+ -� /`2.,1/O�L.1 - - SEPTIC TANK,SEEP,PIT(S) ADDRESS J AND/OR DRAINFIELD S �' r I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE.THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR p DISCONNECT PLUG AND Y 1 LICENSED AS REQUIRED BY S ANGELES COUNTY AND STATE OF i..' CALIFORNIA OR THAT I THE-LEGAL OW* R OF THE . VE ABANDON HOUSE SEWER 41 DESCRIBED RESIDENT! ,P ERTY. 6� BACKFILL SEPTIC TANKS❑ ' „a�, SIGNATURE S SEEP.PIT(S) ❑ CESSPOOLS❑ , OF PERMITTEE �� JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD,CHIEF PLBG. INSPECTOR CK. M.0. CASH x,('06 1 7 3'°`, (iAY 51 0 A 6.00