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Home My Public Portal About9159 EMPEROR AVE_Sewer__ E & F�63 a 6r,�a1254 ■A LOCATION FOR• ■ ER.Y. IT 1 P 6&E y'DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL- Department of County Engmeer County of Los Angeles BUILDIN y_ WM. J FOX, COUNTY ENGINEER ADDRESS t CASSATT D GRIFFIN, SUP T OF BUILDING LOCALITY CRO \ FOR APPLICANT TOHFILL IN NEAR ST — ®" LEGAL ' DESCRIPTION LOT NO OWNER BLOCK TRA V,-kd 9 MAI f AD ES SIZE OF LOT �/� S 9 NO OF BLDG NOW ON LOT EL NO USE OF BUILDINGS DISTRICT NO I GROUP I MAP BK PG CONTRACTOR ADORES CONNECTION DATA C TEL N STATION �'� rp DEPTH ❑ ST E ( O MANHOLE REFERENCE REGISTRATION NO ❑ COUNTY I3 W < LOWER TYPE OF CONNECTP L LENGTH FROM NO DESCRIPTION OF WORK FEE Y CURB M L TO P L HOUSE SEWER CONNECTING TO PUBLICQ $ 3 50 HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR r 1 00 CO IMP NO JOB NO WORK C HOUSE SEWER C� ,V ALTER OR REPAIR EXISTING --SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO R04D PEPMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DISPOSAL SYSTEM 1 00 PERMIT NO SEPTIC TANK, SEEPAGE PIT OR PIIS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL ,.,,�� SPECIAL CONDITIONS ONLY 2 00 FTARGES • CONNECTION CH FEE , OWNER'S PERMIT $ 1 00 11 AUTHORIZATION TOTAL FEEI HAVE HI N NMEDCON- TRACTORT TOS CONNECTO THEA ABODVEV DESCRIBED EXIDATE CNTRCTEITH THE STINGA DWELLING APPROVALS DATE PECTOR S SIGNA TO THE PUBLIC SEW�R SIGNED THIS AY OF / NEW HOUSE SEWER OWNER OR - CONNECT ADDITIONAL OWNERS BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I 1E READ THIS APPLICATION CESSPOOL[IDRYWELL❑ AND STATE THAT THE ABOVE IS CO ECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES D 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 I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIA X20 TY BACKFILL SEPTIC TANKS[ISEEP PITS) ❑ CESSPOOLS SIOF PERMITTEE IAl 2x�__ S f-'-6- aUw . WILLIAM J.-FOX, COUNTY ENGINEERV VALIDATION / BY .ACO 6 9 2 0 AUG 19 4' 4.5 0 By DEPUTY EPUTYa +BY BY ® DEPUTY Y II - � ;76A642%; Y PLICATION FOR PERMIT 1 6&E Fw63 12 84 DIVISION OF BUILDING AND SAFETY SEEE @3-�E91VAC E ®0 S POSH L Department of County Engineer County Of L08 Angeles BUILDINADDRB ULESSG WM J FOX, COUNTY ENGINEER _ �� CASSATT D GRIFFIN, SUP T OF BUILDING LOCALITY (r7/ FOR APPLICANT TO FILL IN NEAREST CROSS ST LEGAL DESCRIPTION LOT NO OWNER BLOCK TRACT MAIL ADDRESS NO OF BLDGS SIZE OF LOT NOW ON LOT CITY TEL NO USE OF BUILDINGS 1 DISTRICT I � I MAP BK PG CONTRACTOR / ADDRESS CONNECTION DATA CITY TEL NO STATION DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO ❑ COUNTY UPPER LOWER TYPE OF CONNECTION LENGTH FROM NO DESCRIPTION OF WORK FEE Y CURB P L _ ML TO P L I HOUSE SEWER CONNECTING TO h r PUBLIC SEWER Q $ ,3 50 HOUSE SEWER CONNECTING TO 1 _ PRIVATE DISPOSAL SYSTEM 100 CONNECT ADDITIONAL BLDG OR CO IMP N0�` _ WORK TO HOUSE SEWER 1 00 .L,/ JOB N ALTER OR REPAIR EXISTING _ SEWER OR DISPOSAL SYSTEM 1 00 TFj N NO ROA ERMIT NO DISCONNECT AND ABANDON SEWER TE ENCROACHMENT AND/OR DISPOSAL SYSTEM 100 PERMIT NO SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DPAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL 'SPECIAL CONDITIONS ONLY 2 00 CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE TRACTORHAVE TTO CON ECTHIS DATE ONTRTHEACTEABODVEWDESCR BED EXISITH THE TIINGNAMED DWELLING APPROVALS DATE INSPECTOR 5 SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF 19 NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) - ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL C3DRYWELL❑ 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 PPOPERLY 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❑ SEEP PIT(S) ❑ CESSPOOLS❑ SIGNATURE OF PERMITTEE WILLIAM J. FOX.COUNTY ENGINEER VALIDATION `.BY ACO gY9 2 1 i AUG 9 4 1 .0 D in DEPUTY DEPUTY BY BY ® DEPUTY DEPUTY