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Home My Public Portal About9745 CRAIGLEE ST_Sewer__ .62 76A642D APPLICATION FOR, PERMIT 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ;j ADDRESS WILLIAM A. JENSEN, Sup't of Building / LOCALITY [BLOCK NEAREST FOR APPLICANT TO FILL IN `ROSS ST. LEGALESCRIPTION LOT NO. 1 OWNERMAIL TRA F ADDRESS NO. OF BLDGS. IZE OF LOT NOW ON LOT CITY TEL. NO. SE OF BUILDINGS DISTRICT NO. GROUP HK MAP P CESSED BY PG CONTRACTOR ADDRESS �J / CONNECTION DATA n' STATION DEPTH - F CI Y �_ TEL. NO .. /�'' C/ �`�✓ / 'I UPPER ` -.% /- (STATE MANHOLE REFERENCE REGISTRATION NO. 6 � ❑ COUNTY NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROMr HOUSE SEWER CONNECTING TO _ Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $5.00 SEPTIC TANK,SEEPAGE PIT OR P.C.NO. �� PITS ANDOR DRAINFIELD @ $10.00 CO.IMP. NO. -106 NO. C�' !! HOUSE SEWER CONNECTING TO T �Rq�AD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAV WAIVER EASEMENT RECORD'.INSTR.NO. DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN..CESSPOOL.DRYWELL.MANHOLE @ $5.00 ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ z o0 AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCR BED EXISTING DWELLING TO THE PUBLIC SE✓E { it APPROVALS DATE INSPECTOR'S SIGNATURE, SIGNED THIS ,� DAY OF ! J!/�� / i �19�,� j1f� OWNER OR NEW HOUSE SEWER �/ OWNERS AGENT _ CONNECT ADDITIONAL � !/ ADDRESS BUILDING OR WORK SEPTIC TANK.SEEP.PITS) I HEREBY ACKNOW4fDGE 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 ❑ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REQUIRED Y LOS ANGLES COUNTY AND STATE OF SEWAGE DIS POSAL SYSTEM CALIFORNIA OR THAT I THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOV DESCRIS RESIDENTIAL P PERTY. ABANDON HOUSE SEWER SIGNATURE OF PERMITTEE BACKFILL SEPTIC TANKS ❑ SEEP.PIT f5)'❑ CESSPOOLS ❑ VALIDATIO ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. CG rr,,AS H2l . r 3 U !1!R J 7. 0 D 7 r1—, 76A642 -61 PPUCn MN FOR p BLOT 76A 642D (� COUNTY OF LOS ANGELES SEWER—SEWAGE Dp OSPOSAla DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A, LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Supt of Building LOCALITY '- NEAREST FOR APPLICANT TO FUL IN CROSS sT. LEGAL DESCRIPTION LOT NO. OWNER BLOCK TRACT MAIL ADDRESS 0.OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO USE OF BUILDINGS DISTRICT NO. GROUP MAP PROCE Ee BY BK _ P6 CONTRACTORIL ADDRESS CONNECTION DATR CITY x TEL.N0. � � STATION DEPTH � p.l -OUTN MANHOLE REFERENCEIL PPER REGISTRATION N0. o.a� G1/ LJ COUNTY NO.. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $0.00 TYPE OF CONNECTION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.L. M.L.TO P.L. PITS AND/OR DRAINFIELD @ $ .00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL.DRYWELL @ S LOO HOUSE SEWER CONNECTING TO P.C.N0. O PRIVATE DISPOSAL SYSTEM @ S .00 CO.IMP. NO. `9et1-N0. CONNECT ADDITIONAL BLDG.OR . ROA PERMITNO. WORK TO HOUSE SEWERTRUNK PERMIT N0 ' S 0 ✓' �� 0: ALT ER OR PAIRO R A SYSTEM HOUSE @ 00 STATE ENCROACHMENT O BANDON PERMIT NO. V Ad 6 INDUSTRIAL UJ r a WASTE APPROV N A HARGES Z OWMR'S PERMIT $ 2 00 CONNECTION CHARGE FLEEIlt rd ALTTTrIORIZATION rTOTAL FEE REIMBURSEMENT FEE ^ I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING FAP 9DTE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. / (,1 SIGNED THIS DAY OF 19— NEW Hous SE R .A Ij� OWNER OR CONNECT A DI ION L [� u OWNERS AGENT. BUILDING WORK '!A ADDRESS SEPTIC TAN SEE PITS) ' AND/OR DRA F15&D 1 Il I HEREBY ACKNOWLEDGE THAT IHAVE READ THIS APPLICATION — /� q i! AND STATE THAT THE ABOVE IS. CORRECT AND AGREE TO COMPLY CESSPOOL [I DRYWELL ❑ n B@ !.:F t WITH ALL-. COUNTY SEWERS. AND STATE LAWS REGULATING ALTER.REPAIR,SEWER OR PLUMBING AN SEWAGE DISPOSAL SYSTE 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ' LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT 1 AM THE LEGAL WNER OF THE ABOVE ABANDON HOUSE SEWER ) DESCRIBED RESIDENT R 1 BACKFILL SEPTIC TANKS ❑ {b SIGNATURE SEEP.PITS ❑ CESSPOOLS OF PERM111111 EE 41 VA MATION ROBERT,/A. WOOD WH SUPERVISING MECHANICAL ENGINEER LPi�O2 8 8 4-.20 APR 5 �1 G D 5.00y. CANCELLED AT REQUEST �- T nr Ur PERMBTTFF �� ./ CE808 3-61 L /� 76A6421:) APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAG DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION F ILDIN�i JOHN A, LAMBIE, County Engineer DRESWILLIAM A. IENSEN, Supt of Building CALIAREST FOR APPLICANT TO FILL IN OSS ST. LEGAL OWNER DESCRIPTION LOT N0. of BLOCK TRACT ADMAIL DRESS N0.OF BLDGS. �� SIZE OF LOT NOW ON LOT CI E NO USE OF BUILDINGS Z DISTRICT GROUP MAP PROCSSEQBY / BIC PG CONTRACTDjjg5 I A ADDRESS C TI DATA LL CITY ` L.NO. STATION — DEPTH REGISTRATION N0. / �. STATE MANHOLE REFERENCE UPPER COUNTY NO. DESCRIPTIGN OF WORT, FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 - TYPE OF CONNECTION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.L. M.L.TO P.L. PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD } EXTN..CESSPOOL.DRYWELL @ S2.00 C' HOUSE SEWER CONNECTING TO P.C.N. [ ` O PRIVATE DISPOSAL SYSTEM @ S1.00 CO. IMP. N0. JOB N0. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. WORK TO HOUSE SEWER @ $1.00 O ALTER. REPAIR DISPOSALSYSTEM HOUSE @ $1 00 STATE ENCROACHMENT (— SEWER PERMIT NO. U LLJ INDUSTRIAL d WASTE APPROVAL rn `=f1�T CHARGES z OWNER'S PERMIT 5 2 OD CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE ev REIMBURSEMENT FEE TRACTOR TO CIONNECT THE ABOVE DESCRIBED EXIISTINGDATE A CONTRACT WITH THE HEREINADWELLIING MED 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 SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD 1 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 SYSTEN 1 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 THA AM THE LEGAL OWNER OF HE ABOVE BACKFILL SEPTIC TANKS ❑ DESCRIBED RESID' PROPE Y. SEEP.PIT(S ❑ CESSPOOLS SIGNATURE ,r� OF PERMITTEE VALMATIOROBERT A. WOOD CK. Y.O. GSN SUPERVISING MECHANICAL ENGINEER 1 67 2w drill , U Q 5C-) �.