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Home My Public Portal About6242 AVON AVE_Sewer__ 1 CEQJC.8 76A6420 APPLICATION FOR PERMIT 76A COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BID E �jISS 242 No,, Avon St JOHN A. LAMBIE, County Engineer WILLIAM A. JENSEN, Sup't of Building LOCALITY 7S o.p�San Gabriel Calif. NEARECROSS$ST.Longden Ave. FOR APP NT ` FILL IN LEGAL u. DESCRIPTION OT N ,,,� OWNER Al T ler Gen COntr . MAIL BLOCK TRACT ( ADDRESS 9959 Woodruff Ave. - NO, OF BLDGS. CITY TEL. No.AT 72657 SIZE OF LOT NOW ON LOT 1 Tem le Cit USE OF BUILD I NGSDwelling DISTR?NO. GROUP MAP 'OCESSED BY BK PG 1! CONTRACTOFjTOk. seph Cadilli Plumbing Co. ADDRESS 7$21 E.Garvey Ave. CONNECTION DATA CITY S.San Gabriel TEL. NO. AT 05349 STATION DEPTH :P STATE REGISTRATION No. 134935 C-36 ❑ COUNTY MANHOL FERENCE ) J LOQ NO. DESCRIPTION OF WORK FEE TYPE OF CONNEC LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB TO P.L. PUBLIC SEWER @ $5.00 SEPTIC TANK.SEEPAGE PIT OR P' PITS AND/OR DRAINFIELD @ $10.00 CO. IMP. NO. JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERM T N '. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 Ift CONNECT ADDITIONAL BLDG.OR AFFIDAVIT wn EN 5E EN F RECORD.INSTR.NO. DATE ] WORK TO HOUSE SEWER @ $3.00 3 00 /'� OVERFLOW SEEPAGE PIT.DRAINFIELD L! EXTN.,CESSPOOL.DRYWELL.MANHOLE @ $5.00 HWY.OR ST.WIDENING 2 ALTER.REPAIR OR ABANDON HOUSE to SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL O� �j� ' ARG ES �•+�++R�S PERMIT $ 2 00 CONNECTION CHARBE'F-EE�� AUTHORIZATION TOTAL FEE OdOF— IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBL)ISEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING / TO THE PUBLIC SE%jEd APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF April ,k4 OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK �/�6 �. s✓+L::(:-.^��,. 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 WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REOUIRE� BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAs I AM THE LEGAL OWNE[2r.OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE �V DESCRIBED ESID filALl PROPERTY. �- ABANDON HOUSE SEWER - SIGNATURE )� El. BACKFILL SEPTIC TANKS OF PERMITTEE f� // - SEEP.PITS) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD � .ff SUPERVISING MECHANICAL ENGINEER M.O. CASH CK i J?.:i ?,� I IJII 14 .:. N CEAAPPLICATION FOR PERM T 76A642D 42D u COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN 11::R.S. ST. LEGAL A/�� DESCRIPTION LOT NO. OWNER ,�/ MAIL BLOCK TRACT ADDRESS012, NO. OF SLOGS. SIZE OF LOT NOW ON LOT I CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS ' CONTRACTOR BKPG / ADDRESS `� CO NECTIObiI�^)DATA (I/- CITY TEL. NO. STATION DEPTH STATE LIC UPPER LICENSE NO, CLASS MANHOLE REFERENCE LOWER NO. .DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. d PUBLIC SEWER @ $5.00 O P.C.NO. SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $10.00 CO. IMP.NO. JOB NO. (J HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 O / CONNECT ADDITIONAL AFFIDAVIT WAIVER EASEMENT RECORD.INSTR.NO. DATE h WORK'T HOUSE SEWER @ $3.00 u OVERFLOW SEEPAGE PIT.ORAINFIELD d EXTN..CES SPOOL.DRYWELL.MANHOLE @ $5.00 (n ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING 9 SEWER OR DISPOSAL SYSTEM @ S3.00 STATE ENCROACHMENT S PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT S1 21 00 CHARGES AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE 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 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK E 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 ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANG S COU TY AND S TE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 11 AM TH L WNE F, A ND TO DISCONNECT PLUG AND RESIDE IN, THE AB RIB 'SIDENT PR ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMt SEEP.PIT'S) ❑ CESSPOOLS ❑ VALIDATION JACK R. ALLEN C SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH 5 3 4 29 Jdfll 1 1 0 0 5.00 76A642 0-63 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �//� T JOHN A. LAMBIE, County Engineer ADDRESS r�� e V / WILLIAM A. JENSEN, Sup't o4 Building LOCALITY FOR APPLICANT TO FILL IN `ROSSSST . U/V Gj>, LEGAL /; DESCRIPTION LOT NO. OWNER (�� F.� _ �,1�O S.w MAIL BLOCK TRACT ADDRESS NO, OF BLDGS. �e-- SIZE OF LOT NOW ON LOT CITY �— TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS BK PG CONTRACTOR ADDRESS � � ' 'a CON ECTION DATA CITY STATION DEPTH �� TEL. NO. ❑ STATE MANHOLE REFERENCE UPPER REGISTRATION NO.� ❑ COUNTY LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER e° $5.00 P.C.NO. �- SEPTIC TANK,SEEPAGE PIT OR JOB NO. O PITS AND/OR DRAINFIELD C $10.00 CO.IMP. NO. V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM e° $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT I WAIVED EASEMENT RECORD.INSTR.NO. DATE O WORK TO HOUSE SEWER @ $3.00 V OVERFLOW SEEPAGE PIT,DRAINFIELD E CESSPOOL,D RYWELL,MANHOLE @ $5.00 LTER EPAIR ORA HWY. OR ST.WIDENING h SEW ERDtBfl95�+.'[�S TEFt��- @° S3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ 2 00 AUTHORIZATION TOTAL FEE S CONNECTION CHARGE FEE 'IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER. 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 WIT HALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,B�.".�,SEWER OR LICENSED AS REQUIRED B LOS ANGLES COUJAND ND STATE OF � ,A;G.E�iF-POSAL SYSTEM CALIFORNIA OR THAT I A THE LEGAL OWNER INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVIA D CRIBED RESID�TyT� PERT ABANDON HOUSE SEWER SIGNATURE,TTEE �� BACKFILL SEPTIC TANKS ❑ OF PERMi SEEP.PITS) El CESSPOOLS El VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH & 34 i 2� NRR '7 1 0 D 5.00- 'i