HomeMy Public PortalAbout9089 EMPEROR AVE_Sewer__ D
IS&E 663 11.98
APPLICATION FOR PERMIT
1
8 @ E 8
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A LAMBIE COUNTY ENGINEER ADDRESS d
® CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY � G��C/
FOR APPLICANT TOp FILL IN CROSS ST
LEGAL
DESCRIPTION LOT NOac2 40e �B OWNER 6 �
MAIL
BLOCK TRACT Z g 00 ADDRESS
NO OF B L D G S CITY TEL NO
SIZE OF LOT NOW ON LOT
USE OF
BUILDINGS DISTRICT NO I GROUP BK JBK MAPP
A
CONTRACTOR
/C 7�
ADDRES ,�_ CONNECTION DATA
'
/ STATION a DEPTH (�
CITY�� /G�4i TEL NO 41 o�,�,.✓� MANHOLE R€NSE® _ UPPE
/� Et"STATE �� lei
I 4 Al
LOWE
REGISTRATION NO ❑ COUNTY
No DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LEN fH FROM
PUBLIC SEWER @ $3 50 Y CURB P L M L TOP L
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFIELD c@ $3 00
OVERFLOW SEEPAGE PIT DRAINFIELD P C NO,
CO IMP NO
EXTN CESSPOOL DRYWELL,MANHOLE @ $2 00 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 PERMIT NO
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE -
OWNER'S PERMIT S1 GG REIMBURSEMENT FEE
AUTHORIZATION I TOTAL FEE
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED coN- APPROVALS DATE INSPECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE D'�RIBED EXISTING DWELLING
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THIS D Y OF 19 CONNECT ADDITIONAL
OWNER OR �' BUILDING OR WORK
OWNERS AGE N SEPTIC TANK,SEEP,PIT(S)
ADDRESS AND/OR DRAINFIELD
I HER Y ACKN,6WLEDGE THAT"I HAVE 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 LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _
DESCRIBED RESIDENTIAL ROPERTY BACKFILL SEPTIC TANKS❑
OF PERMITTEE T /_/
SEEP PIT(S) ❑ CESSPOOLS
SIGNATURE _
JOHN A LAMBIE, COUNTY ENGINEER LIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
CK M 0 CASH
,LOO M10 4 n _4-50
DEP"=MENT OF COUNTY ENGINEER PERMIT
DISPOSAL
1
DNISION OF BUILDING AND SAFETY PERMIT APPLICATIONN
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESSr'4
FOR APPLICANT TO FILL IN LOCALITY }
BUILDINGr 0 hdO NEAREST V
ADDRESS 11 �I,try�a„n :J_ , np—1 CROSS ST t ytLnt
LOCALITY . DISTRICT NO SERIAL NO PERMIT NO
NEAREST /,S
CROSS ST _ !�
�1pp ;;yy--,,� RECEIVED
B�Y///j Ready for Inspection /9DATEC}ISSUED
�\ OWNER f iT :o�la �/ n w ,lr. ( ASN�1/[✓7TlSk °� �lX —$4
MAIL
ADDRESS _a USE ZONE OCCUPANCY I MAP
BK PG
CITY (t ^ TEL NO l
CONTRACTOR �� : CO IMP NO
ADDRESS ~�
�-�, _ JOB NO
CITY i/ yl ?sy� � TEL NO TRUNK PERMIT NO
REGISTRATION NO 113 Q —8TATE
ROAD PERMIT NO
LEGL STATE ENC
DESCRIPTION LOT NO / JJ �'"Y PERMIT NOROACHMENT
O iBLOCK TRACT / Y 9 CIO INDUSTRIAL
c NO OF BLDGS WASTE APPROVAL
SIZE OF LOT ® �� NOW ON LOT
CHARGES
USOF
BUE DINGS CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLICSEWER 0 $ 350 RECEIPT NO I DATE IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1 00
ALTER OR REPAIR EXISTING ���,/y NO I DATE BY
SEWER OR DISPOSAL SYSTEM 100 V "v
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 200 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 200 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ 1 00 Y CURB Pt. ML TOP L
AUTHORIZATION TOTAL FEE I
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE
SIGNED THIS _ �_ _ DAY OF � '�-_ _ _ 19-s ` NEW HOUSE SEW ER ?RcVP�t P� I' J'
J�bI_eYs�� r�
OWNER OR �J ,///��, CONNECT ADDITIONAL
OWNERS AGEN p ' '/�'x�L r""`y" �T¢"�_ BUILDING OR WORK
ADDRESS (1 Q _& fit_ _�f&Cr��_ _ SEPTIC TANK.SEEP PIT(S)
AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL DRYWELL Cj
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS El
SEEP PIT(S)Ej CESSPOOLS El
SIGNATURE
OF PERMITTEE
76A642D 663 1/53
DEFT ENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FDX, COUNTY ENGINEER I BUILDING
ADDRESS 9089 Emporer
FOR APPLICANT TO FILL IN LOCALITY Sn n ('�a ter i P 1
BUILDING NEAREST
ADDRESS 9089 Emporer CROSS ST Ar]c3 Rlvd .
LOCALITY Cv DISTRICT NO. SERIAL NO PERMIT NO.
,ren rahri P] .� A /6 7,r y S
NEAREST
CROSS ST Rosemead Blvd. RECEIVED BY Ready for Inspection DATEISSUED
OWNER AJ). Mae Donald ze .MAIL
ADDRESS 9089 Emporer USE ZONE OCCUPANCY MAP
BK PG
CITYrSan, Gabriel TEL NO
CONTR4CTOR San Marino Plumbing
_ CO.IMP NO
ADDRESS 1465 San Marino Ave JOB NO
CITY San Marino TELNO At 1-1742
TRUNK PERMIT NO
STATE
REGISTRATION NO 962 &COUNTY ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO OF SLOGS
NOW ON LOT CHARGES
USE OF
BUILDINGS CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER @ $ 350 RECEIPT NO DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1 00
ALTER OR REPAIR EXISTING ; NO I DATE I BY
SEWER OR DISPOSAL SYSTEM 1 00
DISCONNECT AND ABANDON SEWER i
_ AND/OR DISPOSAL SYSTEM 100 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2,00 STATION DEPTH
SPECIAL COND T OENS ONLY 200 2 00 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTION LENGTH FROM
OWNERS
PERMIT g 1 00 Y CURB PL ML TOP L
AUTHORIZATION TOTAL FEE 3 00
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
SIGNED THIS -9 -.--DAY OF ..._October_ Iq 53 NEW HOUSE SEWER
CONNECT OWNERS- AGENT L. V ..OWNER ORKeithlev=_ Owner _ BUILD NGORDWORKAL
ADDRESS - 1465 San Marino Ave - SEPTIC TANK,SEEP.PIT(S)
AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL ] DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE Z' /` �G'i
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,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 CALIFO NIA OR THAT I AM/fHE LEGAL OWN-
ER OF THE ABOVE SCRIB:]�
ESIDENTIAL PRO ERTY. BACKFILLSEPTIC TANKS
�
SEEP PIT(S)� CESSPOOLS C]
SIGNATURE
OF PERM ITTE --- _ _ _ .0-E
--- _ - - --- R. �
70A042D 663 1/53