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Home My Public Portal About5204 DOREEN AVE_Sewer__ CEBOB 9-.6I APPLICATION FOR PERMIT TBA 08 3• COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER - BUILDING AND SAFETY DIVISION BUILDING IOHN A. LRMBIE, Cevvty EngiveoI ADDRESS WILLIAM A. IENSEN, Supt of Building_ LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. 22 J LEGAL �f"�✓n _✓ V –DESCRIPTION LOT N0. OWNERMAIL BLOCK a,!�) TRACT –ADDRESS NO.OF BLDGS. ��..� n SIZE OF LOT NOW ON LOT CITY (C . NO i USE OF BUILDINGS .DISTRICT NO. GROUP MAP PROCESSED BY i� BK PO CONTRACTOR _ D ADDRESS g�641K _ CONNECTION DATA CITY A EL.N0. `� !'' ON O DEPTH V REGISTRATION NO. C�0 HTT MANHOLE REFERENCE f C LO ER No. DESCRIPTION OF R FEE HOUSE SEWER CONNECTING TO @ $3.00 SEPTIC TANK.SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FRO PITS AND/OR DRAINFIELD S3.00 Y. CURB P,L. Y.L.TO P.L. OVERFLOW SEEPAGE PIT.DRAINFIELD >' E%TN..CESSPOOL. DR LL LL @ S2.00 S HOUSE SEWER CONNECTING TO P.C.N0. O PRIVATE DISPOSAL SYSTEM @ SL00 CO.IMP..NO. _ 1 JOB N00 U CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. �-" WORK TO HOUSE SEWER SLOG ALTER. AIR ORA 00 STATE ENCROACHMENT _ O ` SEWER DISPOS S @ SI.00 'n PERMIT NO. U INDUSTRIAL a WASTE APPROVAL H �'�in�.,t�nMCHARGES z O.•y, S PERMIT S CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE w REIMBURSEMENT FEE NAMED CN- TRACTOR TO CIONNECT THE ABOVE DESCRIBED- XIISTDATE A CONTRACT WITH THE IING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OP 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 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY f CESSPOOL 0 DRYWELL 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 SEWER CALIFORNIA OR THAT 1 AM THE LEGAL 0 OF THE ABOVE DESCRIBED RESID I L PROPERTY. BACKFILL SEPTIC TANKS 0 SIGNATURE SEEP, PITS 0 CESSPOOLS 11 OF PERMITTEE VALlftTION ROBERT A. WOOD DK. M.0. LAii SUPERVISING MECHANICAL ENGINEER LACo 1 1 3 8 m APR 13 1 1 D 2 5.0 U u"'aNCELL ED F' z Q P RI T E -24 -61 76A6420 APPLICATION FOR PERIMIT 6A 692 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ]OHM A, LAMRIE. Cossety Engqieeer ADDRESS Y �% WILLIAM A: ]ENSEN. Supt of gineer g LOCALITY NEAREST W. FOR APPIJ T TO IN CROSS ST. LEGAL DESCRIPTION LOT NO. OWNER BLOCK TRACT MAIL ADDRESS NO.OF BLDGS. SIZE OF LOT NOW ON LOT r CITY TEL. NO USE OF BUILDING DISTRICT NO. GROUP MAP PROCESSED BY CONTRACTOR BK P6 ADDRESS Z 6— -_CONNECTION DATA C/ , CITY TEL.N0. 7. (f STATION } DEPTH r STATE MANHOLE REFERENCE REGISTRATION NO. 'T./�'. L COUNTY — LOWER N0. I DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO .•.fl PUBLIC SEWER @ 51.00 !/t/ TYPE OF CONNE AND/OR LENGTH FROM . [:7TTANK, EEPAGPIT OR Y. C P.LM.LTO P.L. PS O E @S .00 j OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CESSPOOL.DRYWELL @ S .00 rl, HOUSE SEWER CONNECTING TO •� J, P.C.N0. Q PRIVATE DISPOSAL SYSTEM @ EI 00 CO. IMP. N0. ✓ 0 JOB N0. V CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. WORK TO HOUSE SEWER @ E 00 l' O ALTER.REPAIR PAIRORABANDON HOUSE @ E 00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL W WASTE APPROVAL D. CHARGES z Z OWNER'S PERMIT $ 2 00 CONNECTION CHARGE FEE AUMORMATION TOTAL. FEE REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. TRACTOR TD CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. _ SIGNED THIS my OF 19— NEW HOUSE SEWER S-/ , OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADORES AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 AVE 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 1 AM PROPERLY REGISTERED AND DISCONNECT PLUG AND LICENSED AS REQUIRED�8 OS ANGELES COUNTY ANO ATE OF ABANDON HOUSOSEWER CALIFORNIA OR THA ijI A THE LEGAL OWNER OF E ABOVE DESCRIBED RESIDENT L P PERTY. BACKFILL SEPTIC TANKS ❑ SE .PIT(5) El CESSP92LS SIGNATURE OF PERMITTE VALIDATION ROBERT A. WOOD [[. 9.0. [ASN SUPERVISING MECHANICAL.ENGINEER 0a MAYou 7.00 76A642 -61 PERMITAPPLICATION FOR PERMIT T5 C5808 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDINGAND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engqineer ADDRESS ZG WILLIAM A. JENSEN, S.p't of Bwldiv0 LOCALITY NEAREST FOR APPLICANT TO CROSS LEGAL DESCRIPTION LOT NO. OWNER BLOCK TRACTMAIL ADDRESS N 0 BLOBS. SIZE OF LOT N W •ON LOT CITY TEL. NO USE OF BUILDINGS aDISTRICT N0. GROUP BK MAP PO P CESSED BY - / CONTRACTOR �O S � J-1 ADDRESS CONNECTION DATA CITY TEL.N STION DEPTH �- �.e STATE MANHOLE REFERENCE REGISTRATION N0. W 7i S COUNTY LOWER No. I DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ S .00 T,Y _OF CO d LENGTH FROM PETS AND/OR'DRAENFGELDT OR @ $ 00 Y. L. M.L.TO P.L. S OVERFLOW SEEPAGE PIT.DRAINFIELD ✓ / 1 EXTN.,CESSPOOL.DRYWELL @ jZ.00._ HOUSE SEWER CONNECTING TO y P.C.NO. 0 PRIVATE DISPOSAL SYSTEM @ 1.00 CO.IMP. N0, J JOB NO. U WORK TOT HOOUSEISEWEBLDG.OR 5 .00 TRUNK PERMIT NO. ROAD PERNIT NO. ' O ALTER,REPA R OR ABANDON OUSE STATE ENCROACHMENT f SEWER OR POSAL SYST @ $1.00 PERMIT NO. U INDUSTRIAL a WASTE APPROVAL N CHARGES ? OWNER'S PERMITCONNECTION CHARGE FEE tz�_ AUTHORMATION TOTAL FEEREIMBURSEMENT FEE I HAVE AT DATE A CONTRACT WITH THE CN- TRACTOR TO CIONNECT THE ABOVE DESCRIBED EXIISTIINGAMED DWELL/NG APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THI DA OF 19— NEW HOUSE 5EWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK.SEEP.PIT(S) ADDRES AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE TH 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. �///`may/y'/'p SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I�E RK�� EGISF TH AND/OR DISCONNECT PLUG AND _ LICENSED A PUIRED BY LO LES C NTY AND STATE OF ABANOON HOUSE SEWER CALIFO OR/THAT 1 AM TH LE L NER OF THE ABOVE DESCRI R DENTIAL PROP BACKFILL SEPTIC TANKS ❑ SIGNA SEEP.PIT(S) ❑ CESSP OLS OF P C`� 0 VALIDATION`-N ROBERT A. WOOD CK. M.o, t/aW(/H'�) SUPERVISING MECHANICAL ENGINEER 1( G 8 0 J o Ml%y 18 1 1 D 2 5.0 0 Pi �'vY�•v CE808 3-61 T 6A 64? APPLI 14TION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL ' DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, Coun19 Eeqinee% ADDRESS WILLIAM A. JENSEN, S-11 of Building_ LOCALITY ' NEAREST FOR APPU9,MT TO,FILL IN c3oss sT. LEGAL OWNER DESCRIPTION LOT N0. BLOCK TRACTJIQ MAIL ?a 1 ADDRES N0.OF BLDGS. �j SIZE OF LOT NOW ON LOT CITY USE BUILDINGS DISTRICT 0 NO. GBK PG RO MAP PROCESSED BY ` CONTRACTOR ADDRESS �.��} CONNECTION DATA CITY `j TEL.N0. 3 0 ION �� DEPTX p > 5_ ATEATE MANHOLE REFERENCE REGISTRATION NO. / 37 Q COUNTY LOWER N0. I DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO �O PUBLIC SEWER I. .00 TYPE OF CONNECTION LENGTH FROM ) .. PITS AND/OR DRAENFIELDT OR @ 3300 Y. CURB PP.L. Y.L.TO P.L. 1JJ E%TNOVERFLOW CESSPUOLGORYWELRAINFIELD @ S2.00 -Z� d HOUSE SEWER CONNECTING TO P.C.N0. O PRIVATE DISPOSAL SYSTEM @ 31.00 CO.IMP. N0. 3CR JOB NO. U CONNECT ADDITIONAL BLDG.OR WORK TO HOUSE SEWER 31.00 TRUNK PERMIT N0. ROAD PERMIT N0. Cle O SEWER OR DISPOSAL SYSTEM HOUSE @ $ 1.00 STATE PERMITENCROACHMENT PERMIT N0. INDUSTRIAL W WASTE APPROVAL 4' N CHARGES! lAl IZ OWNFWS PERMIT f 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE HAVE AT THIS DATE A CONTRACT WITH THE TRACTOR TO CONNECT THE ABOVE E CRIBED EXISTIINGADWELLMED ING' APPRO _ I� DATPK ORPF, TOR'3 91GNATURE TO THE PUBLIC SEWER. / SIGNED THIS DAY OP 19— NEW HOUSE SEWER J OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) 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 SYSTEII I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT 1 AM THE L 0 ER OF T E ABOVE DESCRIBED REST BACKFILL SEPTIC TANKS ❑ SIGNATURE EEP.PIT( ❑ CESSPOOLS OF PERMITTE .d ATION ROBERT A. WOOD Ca. U.o. CASH SUPERVISING MECHANICAL ENGINEER Lnu01 1 3 7 e f�R 3 1 0 D 7.00 tq CANCELLED `;zz�« �, ryE�TEE