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Home My Public Portal About9463 BLACKLEY ST_Sewer__ 5INE 6D APPLICATION FOR PERMIT 1 S&E88T�m*_��T OF BUII.DING AND SAFETY SEWER—SEWAGE DISPOSAL `1)epo=tment of County Engineer County of LOS Angeles BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS s LEGAL i�/S _ ./ � OWNER DESCRIPTION LOT NO MAIL Q BLOCK TRACT ADDRESS C ' NO OF BLDGS CITY TEL NO - SIZE OF LOT NOW ON LOT USE OF BUILDIN DISTRICT NO GROUP I MAP BK PG CONTRACTOR CONNECTION DATA ADDRESS STATION CITY EL NO, � ��02 DEPTH MANHOLE REFER NCE _ UPPER y (FATE LOWER REGISTRATION NO �/t �Z ❑ COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM PUBLIC SEWER @ $3 50 Y CURB P L M L TOP L SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD Q $3 00 OVERFLOW SEEPAGE PIT DRAINFIELDP C EXTN CESSPOOL,DRYWELL,MANHOLE Q $2 00 CO IMP NO NO HOUSE SEWER CONNECTING TO ` PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO ROAD P IT NO CONNECT ADDITIONAL BLDG OR STATE ENCROAC NT WORK TO HOUSE SEWER@ $100 PERMIT NO ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL �7� SEWER OR DISPOSAL SYSTEM Q $100 WASTE APPROV a/-1 CHARGES CONNECTION CHARGE FEE _ OWNER'S PERMIT $ 1 00 ' AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SSIGNATURE 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 f OWNERS AGENT 10a:2 `z(! SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY 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 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEW D CALIFORNIA OR THAT I AM THE LEGAL OWNER OF HE ABOVE ER DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(s) ❑ CESSPOOLS❑ OF PERMITTE JOHN A LAMBIE COUNTY ENGINEER V LIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR CK '0'3 O CASH 1 0 3 6 FEB 6 4 A 4.0 0 D)CPAH'11V�NT OF COUNTY ENanvEER SEWER—SEWAGE DISPOSAL �ISIQN OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER I BUILDING ADDRESS / /✓ FOR APPLICANTaTOLL IN LOCALITY /BUILDING i/"/ � �� CNEAREST ROSS STADDRESS G� GIS p� =� rJlt DISTRICT N0. SERIAL NO PERMIT NO LOCALITY /b�^y} �J ll ,C �j NEAREST i J� fJ r I v � A ''ter 4 1e ys CROSS ST 't.K4 �C , ,Q�� RECEIVED BY Ready Ready for IneDeotlen DATE 1g�88UE/D��-2 O W N E R / —/�+��',�/ / / 5i t7 V 1IL ADDRESS � — USE ZOMfr OCCUPANCY A BK PG CITY �L� TEL_NO -7 p JOB NO ADDRESS ,� (►�� ii� �G.(� ✓ b 3 O CITY 9-1"Me ,�TEL NOS b /g b 'DRUNK PERMIT NO STATE REGISTRATION NO `pQ Q ?LJ COUNTY ROAD PERMIT NO LEGAL DESCRIPTION LOT NO STATE ENCROACHMENT PERMIT NO BLOCK TRACT//S,3'/Q/',/ �� 4 ADSUSTRIAL APPROVAL SIZE OF LOT NO OF BLOG6 NOW ON LOT CHARGES USE OF ((�� j BUILDINGS �ZJ` �4? CONNECTION CHARGE FEE NO DESCRIPTION OF WgRK FEE f HOUSE SEWER CONNECTINGITO l REIMBURSEMENT FEE J PUBLIC SEWER @ $ 350- RECEIPT NO I ATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR, Q EXCEPTION R CORDED WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING NO DAT I BY SEWER OR DISPOSAL SYSTEM 100 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 200 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 200 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT ; I 00 Y CURB P L M L TO P L AUTHORIZATION TOTAL FEE 1 _D"117 O N To I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS IN3PECTOR'SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS. _ _ DAY OF ____ ____ _____ _19___ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT _ __ _ _ __ _ ._ _ _ _ BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS _ _ _ - - AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E] DRYWELL CAT IONAND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER OR REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY_L03�ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT IAM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS SIGNAT46- n��' � SEEP PIT(S)� CESSPOOLS URE /OF PERMIT0 _ _ =642D 663 r 1/53 DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL �� s DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J.-FOX. COUNTY ENGINEER BUILDING CABBATT D GRIFFIN, SUPT OF BUILDING ADDRESS FOR APPLIC T TO FILL IN LOCALITY �.y?ijP't�� BUILDING NEAREST f J y r: Edi' ADDRESS CROSS ST i,, LOCALITY` DISTRICT NO SERIAL NO PERMIT NO NEAREST CROSS ST RECEIVED BY Ready for Inspection DATE ISSUED OWNER / �J — !—ZC) —5 MAIL USE ZONE I OCCUPANCY MAP ADDRESS BK PG -- CITY TEL NO CO N'1f{7fGT4R CHARGES REIMBURSEMENT FEE 1 ADDRESS REQUIRED NOT REQUIRED CITY • TEL NO JOB NO ge"_ A--.gam; CONNECTION CHARGE FEE STATE R 0 COUNTY CO IMP NO EGISTRATION �....+� LEGAL1 RECEIPT NO DATE I BY DESCRIPTION LOT NO R BLOCK TRACTWAIVERWAIVER FOR RECORDING SIZE OF LOT,��XaC�D•dD�NOW ON LOTS RECEIPT NO I DATE I BY -, USE OF BUILDINGS k` % — TRUNK PERMIT NO NO I DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO ROAD PERMIT NO, PUBLIC SEWER Ca) $ 350 HOUSE SEWER CONNECTING TO STATE ENCROACHMENT PRIVATE DISPOSAL SYSTEM 1 00 PERMIT NO CONNECT ADDITIONAL BLDG ORINDUSTRIAL WORK TO HOUSE SEWER 100 L (T[� WASTE APPROVAL ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 CONNECTION DATA DISCONNECT AND ABANDON SEWER - / AND/OR DISPOSAL SYSTEM 1 00 STATION �1�7}1 DEPTH 7 SEPTIC TANK,SEEPAGE PIT OR l _ PITS AND/ORDRAINFIELD 2.00 I MANHOLE REFERE�NCE LOWER 1 !�'� ��` ✓ �� CESSPOOL—DRYWELL UPPER— SPECIAL CONDITIONS ONLY 200 I TYPE OF CONNECTION LENGTH FROM ' Y ✓ CURB PL-- MLTOPL OWNERS PERMIT $ I 1 00 - AUTHORIZATION I TOTAL FEE I )-- &10 NAED CO TRACTOIR TO CONNECT THE ABOVE D SCRIBEDDATE CONTRACED WITH THEIEXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS - DAY OF - - --- --- Iq NEW HOUSE SEWER OWNER OR \ CONNECT ADDITIONAL , OWNERS AGENT )! _ BUILDING OR WORK f \ SEPTIC TANK,SEEP PIT(S) ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL❑ DRYWELL❑ CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DFSCR D R SIDEN PROPERTY BACKFILL SEPTIC TANKS❑ SEEP PIT(S)[:] CESSPOOLS E] SIGNATURE OF PERMITTEE 76A642D 663 12/52