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Home My Public Portal About9082 EMPEROR AVE_Sewer__ APPLICATION p��/® pp� PERMIT 8 8 E 868 12 84 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPGSAL Deportment of County Engineer County of Los Angeles BUILDING!24 —1 WM J FOX. COUNTY ENGINEER ADDRESS oc. CASSATT D GRIFFIN SUPT OF BUILDING LOCALITY n FOR APPLICANT TO FILL IN NEAREST CROSS ST LEGAL DESCRIPTION LOT NO OWNER ' zI —t7 BLOCK TRACT MAIL ADDRESS NO 011 BLDGS SIZE OF LOT NOW ON LOT CITY TEL NO USE OFI :I �� BUILDINGS DISTRICT NO GROUP MAP G3 BK PG CONTRACTOR CALIF.SEWER CONST.CO. 15— r ADDRESS 1317 COLEGROVE AVE. CONNECTION DATA CITY MONTEBELLO TEL NOPA. 1+5048 STATION /6 ��,Q DEPTH �A ❑ STATE MANHOLE REFERENCE REGISTRATION NO 148659 (STATE) ❑ COUr LOWER TYPE OF CONNECTION LENGTH FROM NO DESCRIPTION OF WORK FEE P L M L TO P L l.7 HOUSE SEWER CONNECTING TO %1 PUBLIC SEWER Q $ 3 50 (� HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR CO IMP NOSQ/ JOB NO WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING _ SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DIS-OSAL SYSTEM 1 00 PERMIT NO SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES CONNECTION CHARGE FEE OMMIS PERMIT $ 1 00 7 AUTHORIZATION TOTAL FEE Y_&P REIMBURSEMENT FEE IHAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED-CON- V� TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE,, INSPECTOR S SIGNATURE TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THIS. DAY OF IQ JJJ a rr OWNER OR - CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WOPK SEPTIC TANK, SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 VE READ THIS APPLICATION CESSPOOL❑ DRYWELL ClAND 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 I 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 THAT 1 AM E LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP TY BACKFILL SEPTIC TANKS❑ + SEEP PITS) ❑ CESSPOOLS SIGNATURE OF pERMITTE � WILLIAM J FOX,COUNTY ENGINEER VALIDATION AC07 6 1. 2� SEP h 4 4.50 In BY T BY DEPUTY DEPUTY IBY BY °® DEPUTY DEPUTY DEPAHTMFN'r OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER I BUILDING /aD (��e�y�� O �r ADDRESS r/� jr -,�� /�.. FOR APP LIC T TO FILL IN LOCALITY J C, BUILDING NEAREST /D,�r ADDRESS CROSS ST G— ' LOCALITY DISTRICT NO SERIAL NO PERMIT NO c NEAREST `7 �� S CROSS ST EIV TBY Ready for Inspection DA E 1'�E� OWNER �L/ i MAIL USE ZOWIE/ OCCUPANCY MAP ADDRESS BX PG CITY TEL NO CONTRACTOR CO.IMP NO ADDRESS, JOB NO CITY TEL NO 36 TRUNK PERMIT NO REGISTRATION NO // �? COUNTY ROAD PERMIT NO LEGAL C� STATE ENCROACHMEN DESCRIPTION LOT NO PERMIT NO BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT7.P'X (/C' NO OF BL / CHARGES NOW ON LOTT USE OF BUILDINGS �S CONNECTION CHARGE FE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLICSEWER 0 $ 350 RECEIPT NO DATE IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 100 U CONNECT ADDITIONAL BLDG OR XCEPTI N RECORDED WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING ATE IBY SEWER OR DISPOSAL SYSTEM 1 00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1 00 CO N CTION DATA SEPTIC TANK,SEEPAGE PIT OR / PITS AND/OR GRAINFIELD 200 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 200 00 M U[OLE REFERENCE LOWER TYPE OF CONN E IONP LENGTH FROM OWNERS PERMIT $ I 00 Y CURB ML TOP L AUTHORIZATION I TOTAL FEE OG I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED , CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER _ 1 SIGNED THIS. ._._._ DAY OF. _._. ___ ___ ___ 19_ _ NEW HOUSE SEWER ,i �2z OWNER OR CONNECT ADDITIONAL OWNERS AGENT _ _ _._ _ _ _ BUILDING OR WORK SEPTIC TANKSEEP. ADDRESS _ - AND/OR DRAINFIELD PIT(S) ' 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL DRYWELL 0 C /� CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWSI ALTER, PAIR 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 CALIFORMBERE I AM THE LEGAL OWN- ER OF THE AGO V ESENT ALP PERTY BACKFILL SEPTIC TANKS SEEP PIT(S)� CESSPOOLS SIGNATUREOF PERMITT 76A642A 663 7/53