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HomeMy Public PortalAbout5011 ENCINITA AVE_Sewer__ E 76AE42D . CE808 8.68- APPLICATION: FOR PERMIT 7 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL 1 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS 1rOHN A. IJUSIE. County Ea or CIISSATT D. GRIFFIN, Supt of Building LOCALITY eirlPce C;7fy FOR APPLICANT TO FILL IN CROSS ST. L%I/€ ,F'4/e) EGAL ;B /MV JRN DESCRIPTION LOT N0. OWNER /tPs. �/PEtV�c"6 BLOCK TRACT MAIL . ADDRESS O/i NO OF BLDGS. /,Ty SIZE OF LOT NOW ON LOT CITY YJ L C 7fL NO - USE OF amoslown DISTRICT N0.[GROUl ` MAP PROCESSED BY BUILDINGS BK PG CONTRACTOR ��[) 44 ADDRESS ,' /p S. j0 DANA U - CONNECTION DATA CITY a1_ _AJA7� TEL N0. �o�es7 STATION DEPTH REGISTRATION N0. STATE MANHOLE REFEREN E UPPER COUNTY LOWER NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $S 00 TYPE OF CONNECTIOh LENGTH FROM PETS AND/OR,D AENFGE PIT OR @ g3 00 Y. CURB P.L. M.L.TO P.L. OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN CESSPOOL DRYWELL @ $2 00 HOUSE SEWER CONNECTING TO X P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 CO. IMP. NO. / JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NOROAD P T N0. WORK TO HOUSE SEWER @ $1 00 ' ALTER, REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM @ $100 PERMIT NO. - INDUSTRIAL . WASTE APPROV CHARGES OWNERS PERMIT $ 2QQ CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE . 00 REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING A15PROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OF 19_, NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK - ADDRESS SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND 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 DISCONNECT HOUSE D ' CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABO DESCRIBED RID NTIAL PROPERTY. BACKFILL SEPTIC TANKS ❑ , SEEP.PIT(S) ElCESSPOOLS SIGNATURE ❑ ' OF FERMITTE ®P LIDATION ROBERT A. WOOD crc. M.0, CASH SUPERVISING MECHANICAL. ENGINEER ,, '0,5 9- 2 --OPT 2 4` o 0 5.00- cv •�� ,,ter, •-��; +-5 E-66312.54 A PLICATIO V�' ■ ®� 'PERMIT 1 �..- DIVISION OF BUILDING AND SAFETY ! SEWER-SEWAGE D 1 S POSAL. Department of County Engineer psr� County of Los Angeles qO BUILDING - WM. J. FOX. COUNTY ENGINEER Quo64 ADDRESS -�' - CASSATT D.'GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST- e/ CROSS'ST.LEGAL P Ci( DESCRIPTION LOT NO II ',Q OWNER BLOCK I TRACT ��� 'OR r-+ }Q I ' 1W • MAIC - W7y3/- NO. OF BLDGS. t•+ SIZE OF LOT NOW ON LOT CITY TEL. NO. -? USE OF 'w-� _ �/lA . BUILDINGS •�IL7�T.L�/y� �t�'t/i/1 DISTRICT N0. V 'GROUP MAP K PG CONTRACTOR A. ADDRESS �, �Q � CONNECTION DATA - CITY 0-n2,(. TEL. NO. FO P ;iq y STATION '_ 101 0DEPTH ® _ STATE •h1 J^^ EFERENCE REGISTRATION NO. 1 ,� El COUNTY f' UP l4@ TYPCURBNECTION LENGTH FROM NO. - DESCRIPTION OF WORK FEE Y P L. M L TO P L. HOUSE SEWER CONNECTING TO S"U PUBLIC SEWER (t7t $ 3 50 J HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 100 oy� CONNECT ADDITIONAL BLDG. OR 1 00 CO. IMP. N0. 1�-7-7 l -7 JOB NO WORK TO HOUSE SEWER AIII ALTER OR REPAIR EXISTING 7. -SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT N0. ROAD PERMIT"0. �i OW W DISCONNECT AND ABANDON SEWER 'STATE ENCROACHMENT AND/OR DISPOSAL 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 OWNERS PERMIT $ AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON-- - APPROVALS DATE INS'PECTOR•S SIG NATUPE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC'SEWER I s `- �Aw `NEW HOUSE SEWER - SIGNED THIS OF ��y' 19 �I — 4LLP 14 u, CONNECT ADDITIONAL OWNER OR t, BUILDING OR WORK OWNERS AGENT SEPTIC TANK, SEEP, PIT(S) ADDRESS 'AND/OR DRAINFIELD ' I HEREBY ACKNOWLEDGE THAT 1 HAVE READ T IS APP CATION CESSPOOL❑ DRYWELL❑ ANDzSTATE-THAT THE ABOVE IS-CORRECT AND AGREE TO COMPL - - - 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 �pgANDON HOUSE SEWER ' CALIFORNIA OR THAT 1 AM -THE LEGAL OWNER OF THE-ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ SEEP. PIT(S) ❑ CESSPOOLS- 141&4 /'�LCa.�G-•�•-�" SIGNATURE OF PERMITTEE !! - •- WILLIAM J. FOX, COUNTY ENGINEER VALIDATION BY . i 0 9 5 8 ? 6;t0V' 1 A 4:5 r - � BY DEPUTY DEPUTY By BYV ;,® DEPUTY DEPUTY ��q �p q� p� i - p� iso pp y��p e,� , S&E- 6 �1 P P Y p R _6JA tl p N FOR PERMIT Ila RMI Y 8 8 E-889 11.88 /1�9 Y lS.a `ads iirr"�B 99 C7 999 Y e YYY tlsm B 11 ! tl DIVISION OF BUILDING' AND SAFETY SEWER-SEWAGE AGE ®IS POSA,L Deportment of County Engineer County of LOS Angeles BUILDING ADDRESS �J V If �J• JOHN A. LAM�BIE, COUNTY ENGINEER ® CASSATT D GRIFFIN, SUPT OF BUILDING - LOCALITY -' FOR APPLICANT TO FILL IN CROSS ST. r LEGAL DESCRIPTION LOT NO. OWNER r MAIL i BLOCK TRACT ADDRESS ®, � '� ♦ - NO, OF BL 'CITY TEL. N0: SIZE OF LOTS NOW ON LOTT I USE OF - - DISTRICT NO GROUP - MAP BUILDINGS - - .� - BK �PG CONTRACTOR P• 1 - CONNECTION DATA ADDRESSJ/, �%,��`i�,,� pyll e d �I MANHOLE REFERENCE DEPTH CITY _ TEL. N0. UPPER ❑ STATE LOWER REGISTRATION NO. r-' �/. TY NO DESCRIPTION OF WORK FEE ad1 HOUSE SEWER CONNECTING TOTYPE OF CONNECTION LENGTH FROM PUBLIC SEWER @ $,3 50 Y. CURB P.L. M.L. TO P.L. - , SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD © $3 00 OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. N0. EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO IMP NO. JOB NO. HOUSE SEWER CONNECTING TO - PRIVATE DISPOSAL SYSTEM - rQ $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 @ $100 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE - OWNER'S PERMIT S 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE, I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED APPROVALS DATE INSPECTOR SSIGNATURE ' TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER � � NEW HOUSE SEWER SIGNED THIS DAY OF 19U CONNECT ADDITIONAL OWNER OR ,+/ BUILDING OR WORK OWNERS AGENT "� ,yCJ .+ - •J�.vIf - SEPTIC TANK,SEEP, PITS) tADDRESS ^ •i1 AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED 'AND/OR DISCONNECT PLUG AN LICENSED AS REQUIRED BY'LOSANGELD ES COUNTY AND STATE OF ABANDON HOUSE SEW - CALIFORNIA OR THAT I AM THE LEGA1_OWN R OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ , i- SEEP PIT(S) [:jCESSPOOLS SIGNATUR ❑ OF PE JOHN A LAMBIE, COUNTY EN (NEER VALIDATION ROBERT A WOOD, CHIEF'PLBG INSPECTOR CK �co 7 4 8" JUN 2 7 4 2.0 0in