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Home My Public Portal About6332 ENCINITA AVE_Sewer__ 61E-6311.5! APPLICATION FOR PERMIT DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Dep.hneat of County Engineer - County Of Los Angeles BUILDING 33f�hA JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS ////� A �y�, ® CASSATT D. GRIFFIN. SUPT of BuILDING LOCALITY iG/ FOR APPLICANT TO FILL IN CROSS ST. LEGAL I OWNER DESCRIPTION LOT NO. ��' 121 7� MAIL / �•�- BLOCK TRACT ADDRESS(O NO. OF BLDGS. CITY SIZE OF LOT NOW ON LOT USE OF DISTRICT NO. GROUP MAP BUILDINGS RK PG CONTRACTOR L= /�� 9 �•` W4 CONNECTION DATA '. ADDRESS G //�/� STATION DEPTH CITY TEL. NO. 7- UPPER 77 MANHOLE REFEREN E ❑ STATE LOWER - REGISTRATION NO. _ ❑ COUNTY �, No. DESCRIPTION OF WORK FEE - / HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FRO 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. NO. EXTN.,CESSPOOL.DRYWELL,MANHOLE @ $2.00 CO. IMP. N0. JOB NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM C $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER @ $1.00 D'o PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM @ $ 1.00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT s 1 00 �1 �Y REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE y o p c I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- - APPROVALS DATE INSPECTORS SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER ` SIGNED THIS DAY OF 19Z CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ ORYWELL❑ 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 1 AM PROPERLY REGISTERED AND/OR AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT ABANDON NO PLUG PLUGUSE AND CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE WER DESCRIBED REST DENTIALOPE� BA CKF ILL SEPTIC TANKS❑ DESCRIBED EP.KFIL (S) ❑ CESSPOOLS❑ SIGNAT OF PERMITTEE wwwwiiii ��-� JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK. M.0. '[CASH r,3026—. OCi 7 4 2.00 00 SE&E4620 63,,.sB APPLICATION FOR PERMIT6 33�, DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Depaxtment of County Engineer 711 1 County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS . ® CASSATT D. GRIFFIN. SDa'T of BUILDING LOCALITY =NO, PPLICANT TO FILL IN CROSS ST.LEGALOWNER l.i.'LDESCRIPTION LOT N0. //' L - MAIL BLOCK - TRACT- (�, ADDRESSNO. 0@ BLOGS. CITY SIZE OF LOT NOW'r LOT cUSE OF pISTRICTryp . GR MAP BUILDINGS }I {ABK PG CONTRACTO1\�- a e, ',.0 O-N Icunt ADDRESS CONNECTION DATA 6 If ' CITYi �, TEL.N STATION rl DEPTH REGISTRATION NO. l Q S—STATEY MANHOLE REFERENCE I , �F _ UPPER NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TOr TYPE OF CONNECTIOB�T� 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 CO. IMF. NO. (/I ?J Il )OS P. C.NOo.. EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM Q $1.00 - TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER a $1.00 PERMIT N0. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL CHARGES _ CONNECTION CHARGE FEE . OWNER'S PERMIT S 1 00 wog AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'5 SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER LF SIGNED THIS DAY OF 19` CONNECT ADDITIONAL OWNER OR. BUILDING OR WORK _ OWNERS AGENT SEPTICTANK,SEEP, PIT(S) _ ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGETHAT I IBAVE READ THIS APPLICATION 'CESSPOOL D 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 R IRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HO PLUGAUSE D CALIFORNIA TIr T AM_THE LEGAL OWNER OF THE ABOVE DESCRIB ED RE IDENT, LPR ERTY� BACKFILL SEPTIC TANKS El SIGNATURE a SEEP. PIT(S) O.CESSPOOLS D OF PERMITTEE � ' JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A. WOOD. CHIEF PLBG. INSPECTOR _ Cx. M.0, CAS. I - - p 3 1 0 7' DEC 6 4 5 0 �+ W tcWa��r-�