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Home My Public Portal About5003 ARDSLEY DR_Sewer__ i a,E-6D s 83 I f•55 APPLICATION FOR PERMIT S&E-6 1 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL 1 Deportment of County Engineer County of Los Angeles BUILDING ®® JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST LEGAL , OWNER DESCRIPTION T NO. BLOCK TRACT MAIL ADDRESS NO. OF LOGS. ,d�,� I�� CITY TEL. NO. SIZE OF LOT X/j8 NOW ON LOT 6e� USE OF BUILDINGS DISTRICT NO. GROUP MAP BK PG CONYRACTO CONNECTION DATA ADDRESS STATION DEPTH CITY TEL. NO. _ UPPER MANHOLE REFERENCE c E7-rrATE LOWER REGISTRATION N0. /� Cl COUNTY NO. DESCRIP�WORK FEE HOUSE SEWER CONNECTING TOTYPE OF CONNECTION LENGTH F86M Y. CLLRB P.L. M.L. TO L. PUBLiC SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR' PITS PN61OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT, DRAINFIELD J EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $ 2.00 CO. IMP. NO. JOB NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. R PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHM WORK TO HOUSE SEWER @ $1.00 PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 REIMBURSEMENT FEE AUTHORIZATION I TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED coN- APPROVALS DATE INSPECTORS SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER SIGNED THIS DAY OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP,PIT(S) ADDRESS - AND/OR DRAINFIELD 1HEREBY ACKNOWLEDGE THAT I HAVE'READ THIS APPLICATION CESSPOOL 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 I AM PROPERLY REGISTERED /OR DISCONNECT PLUG AND '-- LICENSED AS REQUIRED BY LOS ANG ES COUNTY AND S A OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM HE G L OWN !'JjiTj� ABOVE DESCRIBED RESIDEN R R BACKFILLSEPTIC TANKS❑ SIGNATURE EEP. PIT(S) ❑ CESSPOOLS El OF PERMITTE JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION-, ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. M.O. 6AS 4 6 5 9 Mov 2 9 4.00 «° cesoe•s-sa APPLICATION FOR PERMIT 1 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDIr�NEAR ` r JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Su t of Building g EST 'ry' , FOR APPLICANT TO FILL IN CROSS ST. LEGA L DESCRIPTION LOT NO. J OWNER BLOCK TRACT MAIL ' .. -: .. �•� �, ADDRESS ,,�.:' .'r.• 1'...._,,, NO.OF BLDGS. /t SIZE OF LOT NOW ON LOT ( J'L (�.., CITY TEL.NO. USE BUILDFNGS 7'� DISTRICT NO. GROUP MAP PROCESSED BY _ BK )G CONTRACTOR ADDRESS CONNECTION DATA CITY TEL. N0. STATION , DEPTH ❑ STATE -/ U REGISTRATION NO. LJ COUNTY MANHOLE REFERENCE NO. DESCRIPTION OF WORK FEE OWER HOUSE SEWER CONNECTING TO 4 PUBLIC SEWER @ $3.00 ' SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM PITS AND/OR DRAINFIELD @ $3.00 Y. Ph CURB P.L M.L.TO P.L. OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 HOUSE SEWER CONNECTING TO P.C.N0. PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. NO. JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. WORK TO HOUSE SEWER @ $1.00 _ ALTER, REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM @ $1.00 PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES I OVMER'S PERMIT $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE REIMBURSEMENT 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, SIGNED THISAY OF Jg_ NEW HOUSE SEWER /7 �` -• OWNER OR _— /ID, - CONNECT ADDITIONAL - �... OWNERS AGENT BUILDING OR WORK J ` SEPTIC TANK,SEEP, PIT(S) ADDRESS ��T AND/OR DRAINFIELD _ I HEREBY ACKNOWLEDGE THAT I 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT.. I AM HE. L AL O ;CER THE ABOVE DESCRIBED RESIDENTIAL R BACKFILL SEPTIC TANKS❑ SEEP. PIT(S) ❑ CESSPOOLS ❑ SIGNATURE OF PERMITTE ®R VALMATIO ROBERT A.WOOD CK. J M.O. CAsx SUPERVISING MECHANICAL ENGINEER "I D 5&E-663 11.55- APPLICATION FOR PERMIT 1 S&E-6 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY NEAREST , .9 FOR APPLICANT TO FILL IN CROSS ST. LEGAL OWNER - DESCRIPTION LOT N0. Ad MAIL BLOCK TRACT ADDRESS NO. OF BLDG S. CITY TEL. N0. SIZE OF LOT NOW ON LOT USE OF BUILDINGS DISTRICT NO. GROUP MAP B P CONTRACTOR ADDRESS CONNECTION DA STATION DEPTH CITY TEL. N0. � MANHOLE REFERE E. UPPER REGISTRATION N0. LOWER 6.� (� ❑OUNTY NO. DESCRIPTION!!!OF WORK FEE TYPLOF CON ION MTH FROM HOUSE SEWER CONNECTING TO Y. CUR P.L. M.L..L. TO P.L. PUBLIC SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3.00 -a,, OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. ND. EXTN.,CESSPOOL,DRYWELL,M A N H OLE @ $2.00 CO. IMPANOV JOB NO. 9HOUSE SEWER CONNECTING TO �'•� v Vt PRIVATE DISPOSAL SYSTEM @ $1.00 L.f TRUIX ERMIT N ROAD PERM NO.ft _CONNECT ADDITIONAL BLDG.OR A* bCROACHqAT WORK TO HOUSE SEWER @ $1.00 P IT NO. ALTER,REPAIR OR ABANDON HOUSESTRIAE SEWER OR DISPOSAL SYSTEM @ $1.00 TE APPROVA RGES CONNE I N CHA E OWNERS PERMIT g p AUTHORIZATION I TOTAL FEE IMI SEMENT F E ' I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPRO T INS•EC OR'SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING 'DWELLING TO THE PUBLIC SEWER. NEW HOUSE S SIGNED THIS DAY F 19_ CONNECT ADDI ZONA OWNER OR BUILDING OR VIORK OWNERS AGENT SEPTIC TANK, P, IT(S) ADDRESS AND/OR DRAIN L I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL[IAND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR, E ER OR PLUMBING AND SEWERS. SEWAGE DISPOSA YSTEM 1ICHEREBY CERTIFY THAT i AM PROPERLY REGISTERED AN R DISCONNECT PLUG D LENSED AS REQUIRED BY LOS ANGELE COU TY AN s OF ABANDON HOUSES ER CALIFORNIA OR THAT I TH LE ER OF WIVE DESCRIBED RESIDENTIE SEEPBACKFPIT(SILL EPTIC TANKS❑ CESSPOOLS SIGNATURE 99999 OF'PERMITTEE JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. m.Q. CASH