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Home My Public Portal About9063 EMPEROR AVE_Sewer__ o S&E683 11 89 APPLICATION FOR PERMIT 1 8&E 6 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engineer County of LOS Angeles BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS Q ® CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY / f FOR APPLICANT T9, FILL IN cRoSi ST Scow/ w LEGAL OWNER DESCRIPTION LOT NO AJ / MAIL BLOCK TRACT 5V.%' V (C e- '( ADDRESS NO OF BLDGS J SIZE OF LOT 5rD NOW ON LOT / CITY r 'C I TEL NO USE OF BUILDINGS DISTRICT N GROUP MAP BK PG ' CONTRACTOR � C- W � � � g� ' � CONNECTION DATA ADDRESS _ 011 / �— STATION DEPTH CITY �C� Q � TEL NO �9 MANHOLE REFERENCE f A CLI–STATE foT REGISTRATION NO ( �°Z � ❑ COUNTY „ No DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM PUBLIC SEWER @ $3 50 Y CURB L M L TOP L I SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3 00 OVERFLOW SEEPAGE PIT DRAINFIELD ` P C NO EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO CONNECT ADDITIONAL BLDG OR STATE,ENCROACHMENT WORK TO HOUSE SEWER @ $1 00 PERM[ ,NO ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL .._,�� _ SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVA{. CONNECTION CHARGE FES OWNER'S PERMIT $ t 00 ` REIMBURSEMENT FE AUTHORIZATION I TOTAL FEE �r Q 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 b ,l SIGNED THIS 1DAY OF d >y>A/ CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGEN SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I AAVE 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 I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY S ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I THE LEGA NER OF THE ABOVE DESCRIBED OR PERTY BACKFILL SEPTIC TANKS SIGNATURE SEEP PIT(S) El CESSPOOLSMLf OF PERMITTEiGE JOHN A LAMBIE. C TY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR �K "10Q4 2A1 4 JAN 16 4 4.5 0 to CEBOB3 62 APPLICATION FOR PERMIT 7BA642D COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL _ DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS �`J /�✓-�- COLEMAN W JENKINS SUP T OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN CR°5s 9T n> /,i arc. LEGAL _ _ DESCRIPTION LOT NO OWNER �p'� ' �; (� �n .r `,��p MAIL (� BLOCK TRACT 7 0 �u y5[pl0 d IOJI"`j "0 ADDRESS CIO b 1*42,c t r No OF BLDGS 1 SIZE OF LOT L) NOW ON LOT / CITY TEL NO USE OF71 BUILDINGS 5 DISTRICT NO GROUP MAP PROCESSED BY B K P G ) CONTRACTOR pj , � el ADDRESS Nf 6 392— CONNECTION DATA CITY {} 1 1'!HR-K� TEL NO "(6 ?j l STATION ! I 1. /_ /' DEPTH STATE 4 1-� LIC �(^ LI MANHOLE RI EFE`RF NcE (�V�� ,v` lf� )H, LOWER LICENSE NO ` GLASS �5E1, / i7 LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTIO L NGTH FROM HOUSE SEWER CONNECTING TO Y CURB P L M L TO P L `j rj'— d PUBLIC SEWER @ $5 00 �� PC NO SEPTIC TANK SEEPAGE PIT OR CO IMP NO �� JOB NO O PITS AND/OR DRAINFIELD Q E10 00 V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO w PRIVATE DISPOSAL SYSTEM @ $300 O CONNECT ADDITIONAL BL DG OR AFFIDAVIT WAIYEF EASEMENT RECORD INSTR NO DATE WORK TO HOUSE SEWER @ $300 V OVERFLOW SEEPAGE PIT DRAINFIELD CL EXTN CESSPOOL DR LL MANHOLE 0 85 00 a ' ALTER REPAIR OR ABAND HOUSE HWY OR ST WIDENING H SEWER OR DISPOSAL`SYSTEM @ S3 00 STATE ENCROACHMENT Z PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT s 2AUTHORIZATION TOTAL FEE � CONNECTION CHARGE FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS �� _DAY�OF 19_ OWNER OR �A V �l NEW HOUSE SEWER OWNERS AGENT_ � _/, CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP PIT(S) I HEREBY ACKNOWLEDGE THAT 1 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 I AM PROPERLY REGISTERED AND/OR ALTER REPAIR SEWER OR LICENSEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THELEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PR PERTY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMTTT EE SEEPPIT ❑ CESSPOOLS ❑ VALIDATION JACK R ALLEN 00SUPM o CASH ERVISING MECHANICAL ENGINEER 6 �. 37t S& 4 i 0 0 5.00 s 76A642D 62 - APPLICAT ON FOR PERMI 76A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS COLEMAN W JENKINS SUP T OF BUILDING LOCALITY _ NEAREST FOR APPLICA T TO FILL IN CROSS ST LEGAL DESCRIPTION LOT NO � OWNER AIL BLOCK '1,"J��{ ADDRESS NO Of BLDGS SIZE OF LOT NOW ON LOT CITY TEL NO USE OF DISTRICT NO GROUP MAP &0-ESS BY BUILDINGS ,+ter TN BK PIS CONTRACTOR �r ADDRESS CTIO/ D CITY L NO _/+ STATION//*I' Vol STATE LIC / ✓7 MANHOLE REFERENCE ,uTQ / LOWER LICENSE NO GLASS (�,J (� ( v v� NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB P L ML TO P L 1' PUBLIC SEWER @ $5 00 0 //� O SEPTIC TANK SEEPAGE PIT OR CO IMP NO A!r / JOB NO PITS AND/OR DRAINFIELD @ 510 00 U HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ 53 00 CONNECT ADDITIONAL BLDG OR AFFIDAVIT I WAIY[x [A5101141 RECORD INSTR NO DATE O WORK TO HOUSE SEWER @ $300 O V OVERFLOW SEEPAGE PIT DRAINFIELD W EXTN CESSPOOL DRYWELL MANHOLE @ 5500 I.L. ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING N SEWER OR DISPOSAL SYSTEM @ S300 Z STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL OWNERS PERMIT s 2 00 CONNECTION CHARGE FEE CHARGES AUTHORIZATION TOTAL FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR T0C ONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLISEWER APPROVALS DATE INS ECTOR IGNATURE SIGNED THIS DAY 19_ _ OWNER OR /y � NEW HOUSE SEWER OWNERS AGENT- CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK SEEP PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIT HALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ 1 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 I AM TH LEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND RESIDE IN "AE IBED RESIDEN AL PRO Y ABANDON HOUSE SEWER SIGNAT BACKFILL SEPTIC TANKS ❑ OF T"f FFP PITS) ❑ CESSPOOLS ❑ , VA ATIOJACK R ALLEN CK M o CASH SUPERVISING MECHANICAL ENGINEER LA1 o.5 S -9 2 AUG 1 3 1 0 D 5,0 10