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Home My Public Portal About10827 ARROWOOD ST_Sewer__ D S&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 z c ek ( ® CAS SATT D.GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS STT. n � v'( LEGAL [ OWNER DESCRIPTION LOT N0.` BLOCK TRACT / GI MAIL SS 77// �- ADDRESS L NO. OF BLDGS. CITY �I V(� SIZE OF LOT NOW ON LOT TEL. N0. -r USE BUILDID,NGS DISTRICT NO. GROUP I MAP � BK PG CONTRACTOR Q -„✓ tL s fy�;;;,G�.,.. /t?„�, _ CONNECTION DATA ADDRESS �` � STATION :24,01, o DEPTH r CITY G -�' '� �' TEL. NO. ( 31G , MANHOLE REFERENCE / ❑ STATE W/ L 0 W E—R-j REGISTRATION NO. ❑ COUNTY NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM Z aL �,�1 Y. CURB L. M.L. TO P.L. PUBLIC SEWER @ $ VO / 3,2 SEPTIC TANK,SEEPAGE PIT OR -�4.il�frt PITS AND/OR DRAINFIELD !tip $ 3.00 (� '1 Q'1 OVERFLOW SEEPAGE PIT,DRAINFIELD i ___EXTN.,CESSPOOL,DRYWELL,MAN HOLE ( $$ 2.00 CO. IMP. NO, JOB NO. HOUSE SEWER CONNECTING TO i PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. i� CONNECT ADDITIONAL BLDG.OR STAT ENCROACHMENT � _WORK TO HOUSE SEWER (d $1.00 PERMI _0. ALTER.REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM rt $1.00 _ WASTE APPROVAL C RG�S CONNECTION CHARG E OWNERS PERMIT $ DD REIMBURFEE 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 as 19 CONNECT ADDITIONAL OWNER OR __BUILDING OR WORK OWNERS AGENT �( S `G SEPTIC TANK,SEEP,PIT(S) ADDRESS_Q-ila .e-j. / AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGES 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 AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE SE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANK SIGNATURE SEEP. PIT(s) LlCESSPO' OF PERMITTEE JOHN A. LAMBIE, COUNTY ENGINEER VALIDATIO OBERT A.WOOD, CHIEF PLBG. INSPECTOR CK. N. 0. CASH -' - LACo V DEC 2 2 1 0 A 5.0 0 M r 76808 3-E4 APPLICATION FOR IT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BU LDING e- � JOHN A. LAMBIE, County Engineer ADDRESS W WILLIAM A. JENSEN, Supt of Building �- LOCALITY NEAREST FOR APPLICANT TO F1 CROSS ST LEGAL DESCRIPTION LOT NO. OWNER f MAIL BLOCK TRACT / � ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCE D BY BUILDINGS r• IF BK _1PG CONTRALTO #STATE ~� ADDRESS CONNECTION DATA CITY - T S ON � O DEPTH MANHOLE REFERENCE PER REGISTRATION NO. Q pL� Y NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTIONENGTH FRO d HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.T r_L. PUBLIC SEWER @ $5.00 SEPTIC TANK,SEEPAGE PIT OR P.C.NO O PITS AND/OR DRAINFIELD @ $10.00 CO.IMP. NO. JOB N �+ HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO / U PRIVATE DISPOSAL SYSTEM @ $3.00 ��,,,/// CONNECT ADDITIONAL BLDG.OR AFFIDAVIT waIYER EASEMENT EMENT RECORD.INSTR.N0. DATE WORK TO HOUSE SEWER @ $3.00 O OVERFLOW SEEPAGE PIT,DRAINFIELD V EXTN..CESSPOOL,DRYWELL.MANHOLE @ $5.00 ' LU ALTER,REPAIR OR ABANDON HOUSE HWY.O T. ID I 6 J i �) � SEWER OR DISPOSAL SYSTEM @ $3.0 STATE NCROACH MENT ✓V I N PERMIT NO. z INDUSTRIAL .� WASTE APPROVAL CHARGES /OWrk7PNER'S- s AUTHORIZATION UTHORIZATIO TOTAL FEE CONNECTION CHARGE FEE 'IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN AMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXIST G 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 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING Fr PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER, REPAIR,SEWER OR LICENSED AS REQ I BY LOS ANGLES COUNT AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR T AM THE LEGAL OWNER O AND INTEND TO DISCONNECT PLUG AND RESIDE IN, TVA AB E DESCRIBED IDE IA PROPERTY. ABANDON HOUSE SEWER SIGNATURE -� BACKFILL SEPTIC TANKS ❑ OF PERMI E) ❑ SEEP,PITIS) CESSPOOLS VALI.0. CASH/ ROBERT A WOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH LAC0 2 0 1 6G W126 1 1 0 2 5.0 0, Or 3-64 76A642D APPLICATION FOR PERMIT 6A64 `J COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBUILDING o JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Sup't of Building G LOCALITY 77 NEAREST FOR APPLICANT TP—ILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. OWNER MAIL BLOCK TRACT 06 y V ADDRESS NO, OF SLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF DISTRICT NO. GROUPMAP PROCES SY BUILDINGS CONTRACTOR BK ADDRESS S / GG' �/ CONNECTION!Dt%LJ% CITY G TEL• 'Z� ION DEPTH o / `�� STATE MANHOLE REFERENCE - UPPER REGISTRATION NO. �/�j ❑ COUNTY NO. DESCRIPTION OF WORK FEE TYPE F O ECTIONLENGTH FROM f HOUSE SEWER CONNECTING TO Y C R P,L. M.L.TO P. Q' PUBLIC SEWER @ 55.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR JOB NO. �- PITS AND/OR DRAINFIELD @ S10.00 CO.IMP. NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO O PRIVATE DISPOSAL SYSTEM Q $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD. INSTR.NO. IDATE WORK TO HOUSE SEWER @ $3.00 O OVERFLOW SEEPAGE PIT,DRAINFIELD _ t— EXTN..C ESSPOOL,DRYWELL,MANHOLE @ $5.00 !!l111 V ALTER,REPAIR OR ABANDON HOUSE HWY. S I E I G y a SE ER OR DISPOSAL SYSTEM @ $3.00 STA. CROACHMENT a co r PERMIT NO. INDUSTRIAL WASTE APPROVAL B CHARGES O RAS RMIT s 2 00 CONNECTION CHARGE FEE AUTHORIZATION I YOTAL FEE 'I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN AMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCR ED EXISTING DWELLING TO T,HE PUBLIC SEWER. I APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 1 OWNER OR NEW HOUSE SEWER 6 OWNERS E CONNECT ADDITIONAL BUILDING OR WORK ADDR I HEREBY ACKNOW EDGE THAT i AVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(S) AND STATE THAT T ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITH ALL COUNT ORDINANCES AND STATE LAWS EGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1 HEREBY CERTI Y AT I AM PROPERLY REGI ST ED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS R ED BY LOS ANGLES COUNTY D STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR AT VE M THE LEGA NE OF, D INTEND TO DISCONNECT PLUG AND RESIDE IN, TH ABOV DESCRIBED DEN AL P OPERTY. ABANDON HOUSE SEWER SIGNATURE ` CKFILL SEPTIC TANKS ❑ OF PERMITT SEEP.PITS) ❑ CESSPOOLS ❑ VALIDATIO ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER L&O 2 0 1 5 DD MAY 2 6 1 0 D 7.0 0