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Home My Public Portal About9717 CRAIGLEE ST_Sewer__ CE11118X.62 76A642D OUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL EPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDREss WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST OR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO. �0 OWNER MAIL BLOCK TRACT J ADDRESS NO. O L SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCES 6 BY BUILDINGS -57 () U �y(y/ BK: z' PG CONT RACTO �/SZ� (1 ADDRESS y _ ddd JJJ�� CONNECTION DATA !/ S ATION DEPTH CITY TEL. NO. ) STATE MANHOLE REFERENCE REGISTRATION NO. (0 ❑ COUNTY J � LOWER NO. DESCRIPTION OF W RK EE TYPE OFC NECT N LENGT FROM HOUSE SEWER CONNECTING TO / -U R M.L.T P.L. PUBLIC SEWER @ $5.00 SEPTIC TANK,SEEPAGE PIT OR V - •� P.C.NO. PITS AND/OR DRAI NF I ELD @ $10.00 CO.IMP. NO. J JOB NO. cd ��qq HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT/I O PRIVATE DISPOSAL SYSTEM @ $3.00 IIJJ CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD.INSTR.NO. D E WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD R. EXTN.,CESSPOOL,DRYWELL.MANHOLE @ $5.00 ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WID NI G SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. IND U RIAL WAS E APPROV 00 .' OWNERS PERMIT $ 2 00 H AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN AMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING ' TO THE PUBLIC SEWER. APPROVALS JDATE,,� INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL E j C BUILDING OR WORK /! ADDRESS SEPTIC TANK,SEEP.PIT(S) 1 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 ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE A V DESC BED RESID IAL OPE RTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTE _ SEEP,PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD M.O. CASH SUPERVISING MECHANICAL ENGINEER CK. LAL;0 6 7 3 4 NOV 81 0 Q 7.0 0 Iq - TEMPLE CHTY '/eh 2 D,! '• Il A P P L O C A 'I �®ll V ®R' P E Il 11 11 V Il�T , CE808 9�f8 IIII t1 COUNTY OF LOS ANGELES SEWER—SEWAGE ®9SPOSALL, DEPARTN[ENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBUILDING ADDRESS JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Supt of Building LOCALITY ... .� _ , .'- -.-_. -.•a;. ,. NEAREST ` FOR APP CANT TO FILL IN CROSS ST. LEGAL j DESCRIPTION LOT NO. OWNER BLOCK TRACT •• MAIL. ADDRESS NO.OF BLDGS. - - SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF BUILDINGS DISTRICT NOJ GROUP MAP PROCSiED BY x.. BK' PG I ( CONTRACTOR J/ ADDRESS CONNECTION DATA CITY TEL.NO. �j ION DEPTH TATE Ie MANHOLE REFERENCE' REGISTRATION N0. COUNTY - `�Z z OWER NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 TY OF ON C N LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y L M.L.TO P.L. PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD �I EXTN..CESSPOOL. DRYWELL @ $2.00" HOUSE SEWER CONNECTING TO t g P.C.N0. - v PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. NO. l !— JOB NO. CONNECT ADDITIONAL BLDG.OR WORK TO HOUSE SEWER @ $1.00 TRUNK PERMIT N0. ROAD PERMIT N0. ALTER ORDISPOSAL OR ABANDON HOUSE @ $1 00 STATE ENCROACHMENT PERMIT NO.- IND RIAL WA E APPROVAL OWNS 'S PERMT CONNECTION.CHARGE FEE AUTHORIZATION I TOTAL FEE (1-t? r` REIMBURSEMENT FEE ' 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- :+ s TRACTOR TO CONNECT .THE ABOVE' DESCRIBED EXISTING DWELLING " APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER OR " - CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS 1` SEPTIC TANK,SEEP.PITS) 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 t AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF °�. ABANDONCTULUGAND CALIFORNIA OR THAT 1 AM THE LEGA OWNER OF THE ABOVE BSE SEWER ACKFILL SEPTIC TANKS ❑ DESCRIBED RESIDEN L PRO ERTY. SIGNATURE - ! SEEP.PIT(S) 11 CESSPOOLS ❑ OF PERMITTE - ®P ALMATION ROBERT A. WOOD CIL M.o. CASH SUPERVISING MECHANICAL ENGINEER { 6735 NOV 8 11 D 25.01 N .