Loading...
HomeMy Public PortalAbout5326 ARDEN DR_Sewer__ k : $44650"INSERT J 66606 6-60 //�� ® //L�yT Q �1' FOR.R. tl E RMP �. .78A642U - .;' � _. - COUNTY OF LOS;ANGELES`- S.E W E R _',S E•WAG E D15p®S� 1l ti .DEPARTMENT OF COUNTY ENGINEER '• .'-' BUILDING BUILDING-AND SAFETY DIVISIONADDRESS'_ r',„ ,k >v •..a.Y JOHN A. LAMBIE, CountyEngineer n -WILLIAM A. JENSEN, Sup't of Building LOCALITY ' - - ti,.M, ,.. .__ •.',a..._ ....; �=.F:...g.�.. ;NEAREST- FOR NEAREST . .,CROSS.-ST.`'': r ,. FOR APPLICANT 'T FILL IN LEGAL., `. '.DESCRIPTION -LOT.ND:,. . AWNER , BLOCK' 'TRACT IADDRESS 8 '7 - 'NO.OF BL'DGS. k. r `r SIZE OF LOTS-.:•- -C.....,._- NOW ON-LOT -CITY. TEL NO - USE OF .. BUILDINGS O��' DISTRICT NO. GROUP "MAP P OCESS BY BK PG _ 'CONTRACTOR_ y ADDRESS' ''`n ". CONNECTION DATA ` T TION DEPTH'/to C[TY — ' TEL.NO. ` " ��77 ❑ IF STATE - ` MANHOLE REFERENCE ER: REGISTRATION N0. •G`',;, - - ❑,COUNTY ' No. DESCRIPTI -OF WORK . EE.. e _ HOUSE SEWER CONNECTING TO ' PUBLIC.SEWER •t. ' @ $3.00 d - - s� TYPE CONNECTION - ''LENGTH FROM � 01 SEPT.IGTANK','SEEPAGE-PIT OR • - - .;Y. CURB "P.L.,. •M.L..TO,P.L. PITS AND/OR DRAINFIEL'D , - @ $3:00OVERF $ - v EXTN:.LOW SEEPAGE,PIT,C CESSPOOL. DRYWELLAINFIELD�-@ .$2.00 t •" HOUSE SEWER CONNECTING TO � - �-� ;CO.IMF. " • JOB NO.* t• ' PRIVATE DISPOSAL SYSTEM @ $1.00 CONNECT ADDITIONAL BLDG.OR , -' TRUNK PERMIT N0: ROAD PERMIT N0. �' ' O WORK;TO HOUSE SEWER'. @.$1.00 - - T - .ALTER, REPAIR OR ABANDON HOUSE jSTATE ENCROACHMENT, - '. U S WER'OR DISPOSAL SYSTEM @.-$I'.00' ;PERMIT:NO. 03' - .. INDUSTRIAL .. -'. `WASTEAPPROVA! ` • ' ,. W CHARGES I- O •Eftl I PERMIT '':$ CONNECTION CHARGE FEE - - AUTHORIZATION , TOTAL FEE & QCs - .:REIMBURSEMENT FEE 4 _ 1HAVE AT�THIS DATE A CONi'RACT,WI.TH THE HEREIN;NAMED.CON- _ e Sf _ TRACTOR',TO,.CONNECT..THE ABOVE. DESCRIBED tEXISTING. DWELLING ,APPROVALS, DATE''. INSP,ECTOR'SGNATURE. TOTHEPUBLIC SEWER: ' SIGNED.THI$ DAY OF 19 'NEW HOUSE SEWER p 8_:'t`� e' k. TOWNEROR " - 6 - CONNECT- T ADDITIO AL ° o° OWNERS-AGENTc :BULDI G.ORWORKa.• . - ADDRESS - ,SEPTIC TANK,SEEP.PIT(S)-, g �a 1/lEt' /... _ _ _ _ _ .AND/OR DRAIN Y ;j/1:N. I!A I HEREBY ACKNOWLEDGE-THAT :I HAVE READ THIS APPLICATION - •- „ - -r- bb AND''STATE'THAT'THE.ABOVE. IS CORRECT AND AGREE TO COMPLY CESSPOOL'❑ DRYWELL ❑ ,.f` i J °-WITH ALL COUNTY. ORDINANCES-,A'ND, STATE. LAWS'REGULATING n Al + 'll - ALTER,.REPAIR,SEWER OR_ t •PLUMBING'.A'ND SEWERS. •- ° SEWAGE DISPOSAL SYSTEM t,,HEREBY' CERTIFY THAT I -AM ,PROPERLY REGISTERED .AND/OR LICENSED.'As REQUIRED BY- LOS ANGELES COUNTY...AND°ISTATE. OF DISCONNECT PLUG,AND'. `ABANDON HOUSE'SEWER, ¢ CALIFORNIA. OR THAT 1 AW-THE LEGAL OWNER OF -THE -ABOVE - v. „D,ESC.RIBED'RESIDE TI PROPERTY. BACKFILL SEPTIC'TANKS ❑ _ .S EB-.PIT(S) .❑ CESSPOOL .❑.. SIGNATURES. ' .OF PERMITTE ' -OF VALIDATIO ROBERT A. WOOD' cx. M.o. CASR SUPERVISING MECHANICAL ENG1[VEER s r ' 2465,INSERTS. " - CE808 6.80 APP 1p1 •l,�Fi_® ,�pr 1N���I 1t}�d 1}�r+ [p,�q�q�% •�. t :- .. 76A642D d"-9tl 11 IIeO C .11 ®8©_F10 D 1�_—.R'.YtlB� i •.i} y COUNTY OF'•LOS ANGELES SEl� gR �SEWAGE ®�SPOSAL �` DEPARTMENT OF`COUNTY ENGINEER''" - BUILDING AND SAFETY,DIVISION 'Ao EESSG.. F 4' IOIiN A."LAMBIE. County Engineer �"•. :I i-d ;WILLIAM A. JENSEN, S ip't'of Building LOCALITY n;=... - _ ]NEAREST .� i, i FO,R ;APPLICANT 'TO FILL IN ceoss sr LEGAL. !OWNER �-=i` ���) ? ' DESC IPTION LOT'N0. f MAIL' - BLOCK TRACT -:' ---�' 'ADDRESS,.. •Yo- 1 . NO.'OFBLDGS. - --; SIZE OF LOT•.`-' NOWON LOT'. 6 .. ' (CI.TY- _._ ••TEL..N0. .., ._ USE OF.,, k BUILDINGS, _,i. DISTRICT N0. GROUP _ MAP - .PROCE ED BY "• _. Y s ; BK PG CONTRACTOR ADORE ss �.CONNECTION DATA j ' 'CIT Y .i TEL.NO. .�Ci�fC�ca >: S ION` DEPTH STATEN . :MANHOLE REFERENCE y� ❑ .•"" PER .,. REGISTRATION NO.' li':, _ 0. COUNTY - NO: DESCRIPTI N OF WORK FEE HOUSE SEWER.CONNECTING-TO . ,P.UBLIC SEWER _ _ @ $3.00 - TYPE OFFCONNECTION LENGTH FROM ' SEPTIC TANK,SEEPAGE PIT OR - a,.'C CURB P:L:- •M,L.?0 P.L. b ' -PITS AND/OR DRA1NFIELD + •`@"$3.00 OVERFLOW SEEPAGE PIT, DRAI.NFIELD _ EXTN..7 CESSPOOL DRYW:EiL @ $2.00. •, ,. - HOUSESEIWER CONNECTING TO `` - P.C.N0. '• -PRIVATE.DISPOSAL SYSTEM - '@-$1:00 - CO:^l P:'N0. .�•-JOB NO: , CONNECT_ADDITIONAL BLDG.OR - - TRUNK PERMIT N0." `ROAD'PERM IT N0. 2 ,U WORK TOHOUSE'SEWER, @'$1.00 ' J -J -= , ALTER'. REPAIR OR ABANDON HOUSE - ' .. ';4 .STATE ENCROACHMENT a SEWER-OR DISPOSAL SYSTEM @ $1.00. , ,PERMIT N0. "' d p . - - 1NDUSTR'IAL ' WASTE APPROVAL - W' ".CHARGES- to 'OWNER S,' PERMIT _ $ `2 00', CONNECTION CHARGE FEE AUTHORIZATION TOTAL.FEE' REIMBURSEMENT FEE: I.;HAVE AT`THIS-DATE A CONTRACT WITH THE- HEREIN NAMED CON -- '' • •TRACTOR T6 C-ONNECT THE ABOVE DESCRIBED'EXISTING..DWEL'LING •APPROVALS DATE' INSPECTOR!SSIGNATURE- { TO..THE PUBLIC SEW ER. SIGNED THIS DAY'OF _ <•0 NE'WreouSE SEWER ., , "•- DOWNER OR�:- CONNECTADDITIONAL' -- ` OWNERS AGENT a/ BUIL-DING-0R;WORK ' ADDRESS ..SEPTIC TANK..SEEP.,P.IT(S) .,. :. - 4 - ,-__ .-.,� AND/OR DRAINFIELD. ,I .HER EBY• ACKNOWLEDGE•THAT 4 'HAVE READ THIS APPLICATIOW.- '•--» *;• = "• •^ -•- -,s: 'AN D 'STATE .THAT THE ABOVE IS'CORRECT A`ND. AGREE;TO COMP.LY� ,CESSPOOL.,O DRY,WELL'❑' 'T A! � lye,. WITH 'ALL COUNTY :ORDINANCES-AND STATE LAWS REGULATING, ,ACT.ER,•REPAIR,SEWER-OR.-.;-•. _ - PL'UMBINGiAND SEWERS; ' - " `• SEWAGE"DISPOSACSYSTEM I--HEREBi.'CERTIFY THAT=I AM PROPERLY REGISTERED AND/OR DISCONNECT.PLUG AND LICENSED AS.REQUIRED BY LOS.-ANGELES COUNTY_AND. STATE-OF: ASANDON'HOUSE�SEWER " CALIFORNIA OR THAT 1-.' M THE LEGAL OWNER OF THE ABOVE , DESCRIBED RESIDENT -L OPERTY. ' � ' BACKFILL.SEPTIC'TANKS ❑ - " SIGNATURE SEEP.P-IT,(S).,❑ ,CESSPOOLS • OF PERMITTEE-. �..- ®v LIRA ROBERT WO D _ VA TYO _SUPERVISING MECHANICAL ENGINEER " CK: '.-.65.0. CASH"" ,