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Home My Public Portal About9138 EMPEROR AVE_Sewer__ T6A66 E 12 54 APPLICATION FOR PERI) IT 1 a E e DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOTL Deposimeat of County Engineer County of Los Angeles BUILDING WM. J. FOX, COUNTY ENGINEER ADDRESS + CASSATT D GRIFFIN. SUPT OF BUILDING LOCALITY ° FOR APPLICANT TO FILL IN NEAREST CROSS ST LEGAL 1 DESCRIPTION LOT NO OWNER r BLOCK TRACT MAIL ADDRES NO OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL NO USE OF BUILDINGS DISTRICT NO I GROUP I BK MAP CONTRACTOR CALIF.SEDER CONST.CO. ADDRESS 1317 COLEOROVE AVE. CONNECTION DATA / CITY 14ONTE4ELL0 TEL NOPA. 1-5048 STATION S"�— DEPTH ❑ STATE17 MANHOLE REFERENCE REGISTRATION NO 14C659 (STATE) ❑ COUNTY UPPER TYPE OF CONNECTION LENGTH FROM NO DESCRIPTION OF WORK FEE Y+- P L M L TO P L HOUSE SEWER CONNECTING TO D PUBLIC SEWER �+ $ 3 50 HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR CO IMP NO , 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 200 CHARGES CONNECTION CHARGE FEE OWNER'S pERMT S 1 00 AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE TRACTORHA E TTOSDATE CONNECT THEACTEABODEWITH THE HEREIN DESCR BED EXISTINGADWELLIING APPROVALS DATE INSPECTOR 5 SIGNATURE TO THE PUBLIC SEWER SIGNED THIS47 DAY OF law NEW HOUSE SEWER OWNER OR I CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACK LEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT HE 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 IHEREBY 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 PROP Y BACKFILL SEPTIC TANKS❑ � 93 SEEP PIT(S) ❑ CESSPOOLS6V GC,rx?�.�� SIGNATURE It , OF PERMITTEE WILLIAM J FOX, COUNTY ENGINEER VALIDATION BY Arlo 7 6 0 0 SEP 6 4 4.5 O � DEPUTY _ � DEPUTY 'BY BY 10 ® DEPUTY DEPUTY E-6°83 it-55 S& APPLICATION FOR PERMIT S E-6 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING Q JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS -- ® CASSATT D. GRIFFIN, SUP'T of BUILDING LOCALITY ,�,i Ctt l'h C i J FOR APPLICANT TO FILL IN CROSS ST. LEGAL OWNER DESCRIPTION LOT NO. MAIL BLOCK TRACT ADDRESS NO. OF BLDGS. CITY TEL. NO. SIZE OF LOT NOW ON LOT �r USE BUILDINGS DISTRICT NO. GROUP MAP BK PG CONTRACTOR CONNECTION DATA ADDRESS STATION DEPTH CITY TEL. NO. MANHOLE REFERENCE UPPER Ej STATE LOWER REGISTRATION NO. ❑ COUNTY No. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM PUBLIC SEWER @ $3.50 Y. CURB P.L. M.L.TO P.L. SEPTIC TANK,SEEPAG9 PIT OR _ PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD P. C. NO. I EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 CO. IMP. NO. JOB NO. I HOUSE SEWER CONNECTING TO I PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER a@ $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 $ 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVEAT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER SIGNED THIS DAY OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK _ OWNERS AGENT SEPTIC TANK,SEEP,PIT(S) _ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 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 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 I AM THE LEGAL OWNER OF THE ABOVE --------------- DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP. PIT(S) ElCESSPOOLS(3 OF PERMITTEE JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A`. WOOD,CHIEF PLBG. INSPECTOR CK. V.0. CASH