The URL can be used to link to this page

Home My Public Portal About5312 ENCINITA AVE_Sewer__ KEBOB 10.82 TBA 842D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE ,DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Supt of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS 6T1546 LEGAL ` l DESCRIPTION LOT NO 36 C� OWNER 6 'e MAIL BLOCK TRACT - 71 cJ ADDRESS / A) SIZE OF LOT T NbWOON LOTS CITY /� I ` TEL NO r v USE OF BUILDINGS S / �•P A' DISTRICT NO GROUPI •MAP PROCESSED BY ,{ BK PG CONTRACTOR ;N o ADDRESS p ,,,,,;N CONNECTION DATA STATION DEPTH CITY /K p 'WEL NO : V ' STATE MANHOLE REFERENCE i REGISTRATION NO COUNTY LOWER d NO DESCRIPTION OF WORK - FEE _ TYPE NNECTI N LENG7HFROM , O HOUSE SEWER CONNECTING TO Y �/_ L U PUBLIC SEWER @ $5 00 SEPTIC TANK SEEPAGE PIT GR P C NO 9z PITS AND/OR DRAINFIELD @ S1000 CO IMP NO -IOB NO rO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT PRIVATE DISPOSAL SYSTEM @ $300 CONNECT ADDITIONAL BLDG OR AFFIDAVIT I WAIVER I EASEMENT RECORD INS NO DATE d WORK TO HOUSE SEWER @ $3 00 h OVERFLOW SEEPAGE PIT DRAINFIELD EXTN,CESSPOOL.DRYWELL,MANHOLE @ $500 j AjIJ�Gj ��RAiFt OR ABANDON HOUSE HWY ORST WIDENING � SEWER OR-Di6f�9GP.t-9737EM S300 STATE ENCROACHMENT PERMIT NO INDUSTRIAL _ WASTE APPROVA _ _ CHARGES OWNERS PERMIT 2100, CONNEC ON CHARGE FEE - - AUTHORIZATION TOTAL FEE l I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE _ TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER - q - o _ APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF -- OWNER OR NEW HOUSE SEWER - - OWNERS AGENT _ CONNECT ADDITIONAL BUILDING OR_W ORK ADDRESS SEPTIC TANK SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING - PLUMBING AND SEWERS - CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM. PROPERLY' REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN THE-ABOVE DESCRIBED N AL P OP TY ABANDON HOUSE SEWER _ SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP,PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT,A. WOOD cK M O CASH SUPERVISING MECHAN`ICAL'ENGINEER �: �J 5 7 9 a a 5.0 0 M r` 76A642D-63 APPLICATION FOR PER IT +I COUNTY OF LOS ANGELES SEWER—SEWAGE•DISPOSaL DEPARTMENT OF,COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAREST JOHN A. LAMBIE, County Engineer WILLIAM A. JENSEN, Supt of Building f G �' FOR APPLICANTTO LL IN /) LEGAL /� -/,d / • /�( �/� DESCRIPTION LOT NO Q OWNER ( / /.J l✓� MAIL / ,f BLOCK TRACT ADORE `'ICf • NO OF SLOGS SIZE OF LOT NOW ON LOT / CITY TEL NO USE OF BUILDINGS DISTRICT N GROUP MAP _ PROCE D BY BK PG CONTRACTO �-) ADDRESS f CON ECTION hATA CITY TEL ON 0DEPTH STATE REGISTRATION NO / J�O"�� COUNTY MANHOLE REFERENCE /, PER NO DESCRIPTION OF WORK FEE TYPE OF O T LENG,4A FROM HOUSE SEWER CONNECTING TO - Y P L M L O P L PUBLIC SEWER @ $5 00 PC NO O SEPTIC TANK,SEEPAGE PIT OR JOB NO PITS AND/OR DRAINFIELD ® SIOOO CO IMP NO / r JJJ V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT /_ --2 PRIVATE DISPOSAL SYSTEM @ $3 00 i/J ✓�p ^ CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVER EASEMENT RECORD INSTR NO DATE WORK TO HOUSE SEWER @ $3 00 V OVERFLOW SEEPAGE PIT DRAINFIELD W E%TN CESSPOOL,DRYWELL,MANHOLE @ $5 00 0' ALTER REPAIR OR ABANDON HOUSE O ST ID I N SEWER OR DISPOSAL SYSTEM @ $3 00 T R ACHMENT - Z PERMIT NO INDUSTRIAL WASTE APPROVAL ' OWNERS PERMIT s i 00 CHARGES AUTHORIZATIONTOTAL FEE CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN IdAMED CON REIMBURSEMENT FEE TRACTOR ATO CONNECT THE ABOVE DESCRIBED E%IST ING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATU E SIGNED THIS OA �OF 19_ - OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR_WORKSEPTIC I HEREBY ACKNOWLEDGE THAT I'HAVE READ THIS APPLICATION AND/O TANK SEEP,PIT(S) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY NDR DRAINFIELD WITH ALL COUNTY ORDINANCES AND STATE LAWS 'REGULATING PLUMBING AND SEWERS _ - CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSEDAS REOUI D BY LOS ANGLES COUNTY D STATE OF SEWAGE DISPOSAL SYSTEM - CALIFORNIA OR TH THE LEGAOOE R OF, A D INTEND TO DISCONNECT PLUG AND RESIDE IN, THE VE ESCRIBED RTPERT ABANDON HOUSE SEWER SIGNATURE BACKFILLSEPTIC TANKS ❑ OF PERMITTEE SEEP PIT(S) ❑ CESSPOOLS ❑ ' VALIDATION ROBERT A. WOOD CK M O- CASH SUPERVISING MECHANICAL ENGINEER Zo APR 1 7 1 0 Q 7,00-- 7 6A642D,°-63 76A64APPLICATI FOR PERMI COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS Z WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST FOR APPLICANT TO FI IN CROSS ST LEGAL DESCRIPTIO LOT NO OWNER MAIL / lof BLOCK TRACT j Z ADDR NO OF BLDGS SIZE OF LOT NOW ON LOT CITY ` - TEL NO USE OF DISTRICT NO GROUP MAP PROCES BY BUILDINGS BK PG CONTRACTOR ADDRESSV UUU CONNECTION DATA CITY E P TION DEPTH i /) STATE MANHOLE REFERENCE PPER REGISTRATION NO COUNTY NO DESCRIPTION OF WORK FEE TYPE OFCO N TION ` L GTH FROM / HOUSE SEWER CONNECTING TO ,Y ! O �c L M L TOP L PUBLIC SEWER @ $5 00 } P C NO ti SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ 51000 CO IMP NO JOB NO O U HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT PRIVATE DISPOSAL SYSTEM @ $3 00 I= CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVER EASEMENT RECORD INSTR NO DATE O WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT,DRAINFIELD L!J EXTN CES L,DRYWELL MANHOLE @ $500 ALTER, IR OR ABANDO OUSE O ST W EN9N Z SEWER DISPO AL S S300 E NCROAC•H�M E/NT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ AUTHORIZATION TOTAL FEE Jc� CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER DATE INSPECTOR'S SIGNATURE SIGNED THIS 4`%�OF OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTE D AND/OR ALTER REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLESCO TY D ATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THA M THE LEGAL OWN OF, D TEND TO DISCONNECT PLUG AND RESIDE IN THE A E ESCRIBED RESIDE L OP TY ABANDON HOUSE SEWER SIGNATURE J BACKFILL OF PERMITTEE SEPTIC TANKS ❑ PIT(S) ❑ CESSPOOLS ❑ VALIDATIO ROBERT A. WOOD SU CK M O ERVISING MECHANICAL ENGINEER CASH Li bo 7 8 2 7 APR 17 1 1 D 2 5.0 0