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Home My Public Portal About9559 BLACKLEY ST_Sewer__ DEPAIirMENT OF COUNTY ENGINEER . SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BDSS DREUILDING r,[� /� 77I A9�J�J 9 �A�j JC / FOR APPLICANT TO F LL !,N, LOCALITY BUILDING �� Le �_/e% lXis*.�4 NEAREST�I��!/��J ADDRESS / CROSS ST G�y � '�_ DISTRICT�Ip. SERIAL N0�- ENO. LOCALITY / C�ce��c.•,/ S A 6/ S NEAREST .� /, le CROSS STR IV BY Ready for Inspection DATE ISSUED OWNER Z. G/ MAIL ,oma USE ZO OCCUPANCY •-i�tA�P-' -AD DRES f _ BK PG CITY -?2-le'4-'e-��,%TEL.NO. Z /9 CONTRACTOR �, 7 7 ADDRESS /moiV,045fJOB N0. y� CITY �/,4 TEL.NO. DI e` .�C TRUNK PERMIT NO. REGISTRATION NO. � 3� Ik� � ROAD PERMIT N0. ,Z� 77 j S'y� LEGALSTATE ENCROACHMENT DESCRIPTION LOT N0. • PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOTM?X 31V N0.OF BLDGS. CHA ES NOW ON LOT USE CONNECTION CHARG FEE -/2- BUILDINGS NGS - NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER @ $ 3.50 RECEIPT NO. DATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTIO RECORDED WORT(TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. I D E I BY _SEWER'OR•DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER _ AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA - SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION - 74 7• `S— DEPTH-• CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00T Z MAN 0 FERENCEif/I T 3�!/ PIP EBSR TYPE OF CONNECTION -LENGTH FROM OWNERS ; I 00 Y. r �' M.L:TO P.L. PERMIT - - AUTHORIZATION I TOTAL FEE '/ "-,* • ` I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE'ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING.TO TUE PUBLIC SEWER e SIGNED THIS. ...f OF- ____�_________..19 _a� NEW HOUSE SEWER 5 OWNER OR - CONNECT ADDITIONAL OWNERS AGENT................_--- BUILDING OR WORK �•'� 4 f- SEPTIC TANK•SEEP.PIT(S). . ADDRESS.-.� _„ - g- y -- AND/ORD RAINFIELD IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI CESSPOOL[:] DRYWELL E] TION AND 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 LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SEEP.PIT(S)[:] CESSPOOLS El SIGNATURE y !��-=_ a OF PERMITTEEJ� __�__--•----'_`-----._.._.._ _ .-•-----._... 76A642A 663 7/53 /j�` �l ✓ iI1 DEPARTMENT OF COUNTY ENGEVEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER I BUILDING J�� / C�1T ADDRESS �!/ J /% �J+� � FOR APPLICANI TO FILL IN LOCALITY BUILDING — `� NEAREST ADDRESS G G.-� CROSS ST. LOCALITY T DISTRICT NO. SERIAL NO. PERMIT N0. NEAREST CROSS ST. A �'��. w�^ V REIB Ready for Inspection DATE ISSUED OWNER.MAILUS 6j� =ON OCCUPANCY ADDRESS r G B`�M�MI► CITY EL.NO. �S I /q�J CONTRACTOR Z? 7 ADDRESS JOB NO. y CITY TELAO. TRUNK PERMIT NO. ❑ STATE REGISTRATION NO. ❑ COUNTY ROAD PERMIT NO. LEGAL15 �/ C 1O` STATE ENCROACHMENT _ DESCRIPTION LOT N0. rf' J PERMIT NO. BLOCK TRACT� S�Q/t��E� OT INDUSTRIAL WASTE APPROVAL _ SIZE OF LOT 0.OF BLDG—S.-CHARGES NOW ON LOT USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECT NG TO PUBLICSEWER $ 3.50 RECEIPT�1 � �� /iTE I BY HOUSE SEWER CONNECTt TO { j� PRIVATE DISPOSAL SYSTE I.00 4�vl CONNECT ADDITIONAL BLD 0 EXCEPTION CORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. DATE BY SEWER OR DISPOSAL SYST 1 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYST M 1.00 CONNECTION DATA SEPTIC TANK,SEEPA PIT OR --PITS AND/OR DRAINF LD 2.00 STATION DEPTH CESSPOOL—DRYWE SPECIAL CONDITIO S ONLY 2.00 MANIH F FERENCE LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ 1 00 Y. CURB L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE SIGNED THIS....................DAY OF......._...............................19----.--- NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS 'AGENT...........-......_...... _ BUILDING OR WORK SEPTIC TANK,SEEP.PITS) ADDRESS..-------•---------------------------------------------:................................... AND/ORDRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E] DRYWELL E] CATION AND 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 I HEREBY CERTIFY THAT 1 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 ABOYq DESCRIBED RESID AL PROPERTY. BACKFI LL SEPTIC TANKS C] SEEP.PIT(S) CESSPOOLS SIGNATURE OF PERMITTE . .------ --- ----.. 76A642A 663 7/53