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Home My Public Portal About6355 ENCINITA AVE_Sewer__ CE808 5-65 APPLICATION FOR PERM ^ ]6A fii2D COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BULDING 3S.S �G rTN� .I01IN A. LAM111P:. County Hnginacr ADDRESS COLMIAN W. JESAINS,Supt.of Building �/ .• LO<ALITY NEAREST FOR APPLICANT TO FILL IN CEDES SlL LEGAL DESCRIPTION LOT NO. z__21 OWNER // A J2) / MAIL BLOCK TRACT // C`y ADDRESS NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO, USE OF DISTRICT NO. GROUP MAP PROLES O BY BUILDINGS BK PG CONTRACTOR /LC�Sc.� ADDRESS /i�Q �COTTI�J/ `l�/ CONNECTION DATA CITY �y TEL. NO� (� 'J,,JJ STATION 9j? i. J( / Q DEPTH LICE (� UPPER NO. CLA 55 3 MANHOLE DEFERENCCEE LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FRO HOUSE SEWERCONNECTING TO Y. CURD PUBLIC SEWER C' $ 5.00 } SEYTIf TANA. GE P T OR P.C.NO. y PITS AND/OR DRAINFIELD C $10.00 CO.IMP.NO. JOB NO, 0 HOUSE SEWER CONNECTING TO TRUNK PERM IT ROAD PERMIT NO. v PRIVATE DISPOSAL SYSTEM.. fl S 3.00 CONNECT ADDITIONAL BLOC. OR AFFIDAVIT uv uslx[xT RECORD, NSTR.NO. DATE O WORK TO HOUSE SEWER ? $ 3.00 W ev ATiEra-cSnxA�a-«�iw�E SEWER OR-BKPBSAL SYSTEM f S 3.00 Q U --�ATt SSPOO HWY.OR ST.WIDENING d E%T N.,CESS POOL. MANHOLE f$ 5.00 STATE ENCROACHMENT Z PERCOLATION TEST C $ 5.015 PERMIT NO. INDUSTRIAL WASTE USTRIA APPROVAL CHARGE$ O RS PERMIT s z 00 AUTh RIZATION TOTAL FEE U 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 TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR-5 SIGNATURE SIGNED THIS DAV OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL OR BUILDING OR WORK ADDRESS SEPTIC TANK.SEEP. PIT(5) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ ORYWELL ❑ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND BTATE OF SEWAGE DISPOSAL SYSTEM •" ✓ (J > CALIFORNIA OR THAT 1 M THE LEGAL NER F. PND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE A OB VE OESCIjIBEQ IDENT L P OP TY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE ❑ — - — SEEP,PIT I51 ❑ CESSPOOLS ALIDATION CK M.O. CASH 5 0 7 7-� OCT 3 10 D 5.00Al ° 76A642OAPPLICATION FOR PERMIT 1 S e E-663 12-54 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County Engineer County of Los AngelesBUIADDRESS LDING g"?��S4/VG / /v 1 T0. WM. J. FOX. COUNTY ENGINEER ` /� CASSATT D. GRIFFIN, SUPT of BUILDING LOCALITY 1�'1L 1`t C T C.&/. FOR APPLICANT TO FILL IN NEAREST n 1 t CROSS ST. ,W A_ f_ LEGAL �A DESCRIPTION LOT N0. OWNER � Q W LS � �• TI YR Z.Z(� Q �0(N5 BLOCK TRACT 'a ' IS ' MAIL ADDRESS- ,..�( 1 �+' NO. OF BLOGS. 1� +�1 ,t,�/U /� I SIZE OF LOT /� 1 J b NOW ON LOT L� CITY 11/MPkL C. TEL. NO. r -1 rr ZD USE OF BUILDINGS DISTRICT NO. GROUP MAP / BK PG CONTRACTOR 0 ADDRESS /oZQ�, j1,L�w 1 J CONNECTION DATA CITY Y— E STATION , DEPTH /} ❑ STATEa/O, 0 MANHOLE REFERENCE REGISTRATION N0. ❑ COUNTY /J� UPPER y9ygg.. TYPE OF CONNECTION LENGTH FROM 9' /YV NO. DESCRIPTION OF WORK FEE X .- CURB -RCL, M.L.TO P.L. OC II HOUSE SEWER CONNECTING TO PUBLIC SEWER ({il $ 3.50 - HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00CONNECT ADDITIONAL 7 -WORK TO HOUSE SEWER LOG. OR 1.00 / / 9 / CO. IMP. NO. JOB. NO. ALTER OR REPAIR EXISTING ,Z,4 O/O/ ,7 SEWER OR DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. ROAD PERMIT N0. DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DISPOSAL SYSTEM 1.00 PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR _ PITS AND/OR ORAINFIELD 2.00 INDUSTRIAL CESSPOOL- ORYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2.00 CHARGES CONNECTION CHARGE FEE OWNERS PERD4IT S 1 00 AUTHORIZATION ITOTAL FEE J 47 ' REIMBURSEMENT FEE MED CCN� TRACTORT TO CONNECT DATE O THE ABOVE CTED WDESCRIBED ITH THE H EXISTING EREIN A DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC 5 ER SIGNED THIS T DAY OF r�h't_tt" (g NEW HOUSE SEWEROWNER q CONNECT ADDITIONAL OWNERS AGENT ��Q�,(y �A1� ♦ BUILDING OR WORK ! 4IRLL SEPTIC TANK, SEEP, PIT(S) ADDRESS D3 y I TIIADRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE 15 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 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ SIGNATURE 0 ///�7 SEEP. PIT(5 ES ❑ CSPOOLS OF PER MiTTEE( � WILLIAM J. FOX,COUNTY ENGINEER VALIDATION i BY _{Ga9 a 7 3U` OCT 21 4 5.5 0 ID DEPUTY DEPUTY BY BY ® DEPUTY %v DEPUTY 76A 642D - CE806 _ 9/73 APPLI�C7N FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING - •/ 1 � wooREss LOCALITY FOR APPLICANT TO FILL IN NEAREST L CRO55 3T. LEGAL � / L DESCRIPTION LOT NO. OWNER G C MAIL BLOCK +— TRACT ADDRESS441 (/G NO. OF BLDG5. Ay SIZE OF LO S NOW ON LOT CITY � EL. NO. +�} USE OF DISTRICT NO. GflOUP MAP OC E55E0 BY BUILDINGS gK pS CONTRACTOR ADDRESS CONNECTION DATA CITY TEC. NO. TATION DEPTH STATE LIC NHOLE REFERENCE UPPER LICENSE NO. CLASS LOWER NO. DESCRIPTION OF WORK FEE EOF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER 6 E7.00 'SEPTIC -ANK.SEEPAGE PIT—OR P.C.NO. PITS qNO/OR DRAINFIELD ® SIO.00 CO.IMP. NO. JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROADIT NO. PRIVATE DISPOSAL SYSTEM $3.00 CONNECT ADDITIONAL BLD .OR O AFFIDAVIT I WAIVtR tASUkItNT RECORD.I NSTR.NO. GATE L �^HOUSE SEWER ® $3.00 OVERFLOW SEEPAGE PIT.DRAIN IELD V E%TN..CESSPOOL.DRYWELL. ® ".00 ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING S EWER O R DISPOSAL SYSTEM ® S3.00 STATE ENCROACHMENT CD MANHOLE ® $7.00 PERMIT NO. V --- INDUSTRIAL CW GO �� }� WASTE APPROVAL Z OWNER'S PERMIT E 0 CHARGES — AUTHORMATION TOTAL FEE O CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEW E DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF zmf419 OW NER OR NEW HOUSE SEWER /) OWNERS AG ENT��lf Ofi1s�Q.�1�i, E(✓JYCQtU / CONNECT ADDITIONAL �� y_ AODRE53r"3 S.S/4�l /YLi/�/�/T /, Li I BUILDING OR WORK �A(Ji SEPTI<TANK.SEEP.PIT(5_) I HEREBY ACKNOWLEDGE THAT 1 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 FLU MBING AND SEWERS. CESSPOOL (3 DRYWELL 0 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ALTER.REPAIR.SEWER OR LICENSED AS REOUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL.SYSTEM CALIFCANIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE 0 OF PERMITTEE BACK FILL SEPTI �S SEEP,PITIS) CESSPIOOLS ❑ VALIDtlION SCK' M.O. CASH 99 -0 pGT 3 i 0 D y•Gv � �