HomeMy Public PortalAbout9861 ESTRELLA AVE_Sewer__ s5&64e.2D° F55 APPLICATION FOR PERMIT
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DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Deportment of County Engineer - ."
County of Los Angeles BUILDING �` c✓ 71'/�•
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS n f0 J' L V
® i CASSATT D. GRIFFIN. SUP'T OF B°IE°IN G -_ �+ / '
LOCALITY J,�ftf7 '• ` [ •�p 'y �•f.'
FOR APPLICANT TO FILL IN CROSS ST. ��/V• �� .
LEGAL OWNERS
DESCRIPTION LOT N0.
MAIL.
BLOCK 'TRAACT t ' /(. 7 /2 ADD S ?O' JJ //'L �^�, �•f
SIZE OF LOT�.� / L{ O NOW�ON LOTS / CITY TEL.'N0./f ^ ! �� /-J ,
USE OF " DISTRICT 0. GROUP MAP
BUILDINGS / `
su �^' - BK PG
CONTRACTOR � JL L Q ?
ADDRESS _`�4F� 917 .y,� ,a, CONNECTION DATA •�
�uI ,�_ '� STATION S . Q DEPTH,
CITY J�E71?..�.-I _JEL. NO. ��(*d � .
_ h e_ _ _ MANHOLE REFERENCE /O
REGISTRATION NO. '/ J/ ❑ COUNTY _ OWER
NO. DESCRIPTION OF WORK- FEE 7
HOUSE SEWER CONNECTING TO Y TYPE OF CURB /ION P.L. LENGTH P.L.TH M '
PUBLIC SEWER @ $ OO. `�
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. �/ ///777
HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. `731
HOUSE
SEWERISPOSAL
'@ 51.00
CONNECT ADDITIONAL BLDG,OR STATE ENCROACHMENT
WORK TO HOUSE SEWER $1.00 PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
.SEWER OR DISPOSAL SYSTE M @ $1.00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT S Oo
AUTHORIZATION TOTAL. FEE REIMBURSEMENT FEE-I
1 HAVE"AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS- _ DATE INS PECTORIS SIGN ATURE
TRACTOR TO CONNECT THE ABOVE. DESCRIB D EXISTING DWELLING
TO-THE PUBLIC SE ER. NEW HOUSE SEWER �1 41.��+� ���p `_•
SIGNED'TZI DAY OF • 19 _ CONNECT ADDITIONAL
OWNER. OR.. BUILDING OR WORK -
OWNERS AGENT SEPTIC TANK,SEEP, PITS) -
ADDRESS AND/OR DRAINFIELD
I HEREBY ACI OWLEDGE T AT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑.
AND STATE .THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINAN C E 5
AND STATE LAWS REGULATING t ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. - SEWAGE DISPOSAL SYSTEM
I'HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR AND
DISCONNECT PLUG
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HO PLUGUSE D /
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER'OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. / BACKFISTANKS EI/f
SIGNATURE / SEEP. PIT IT.(B) 0 CESSPOOLS
OF PERMITTEE ���A��^•
JOHN A. LAMBIE. COUNTY ENGINEER - VALIDAT ROBERT A.,WOOD, CHIEF PI-BG.,INSPECTOR
crc. X. 0. sH -
Lko - 3_0�7'N Wv 310 A ` Jr.O 0 .
TEMPLE C9TY
ESOS D 8-bB
CAPPLICATION FOR PERMIT G1
E808 II
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL 1115
DEPARTMENT OF COUNTY ENGINEER -- _ --
BUILDING AND SAFETY DIVISION BUILDIADDRESNG 4 D
IORN A. LAI County Evg�neer r i
CASSATT D. GRIFFIN, Supt of Building LOCALITY
fi
NEAREST
FOR APPLICANT TO FILL IN DROSS ST. _
LEGAL �%
DESCRIPTION LOT NO. OWNER
BLOCK TRACT MAIL
:tb �- ) ADORES, _
NO.OF BLDGS. r
S12E OF LOT NOW ON LOT CITY "TEL. NO.
USE OF
'
BUTLDINGS
TOR c TRI . GROUP I S
MAP S I ZZ
CONICESS�BY
Y ADDRESS CONNECTION DATA
CITY TEL.NO. STATION DEPTH
STATE MANHOLE REFERENCE _ UPPER
REGISTRATION NO. ❑ COUNTY LOWER
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ $3.00 TYPE OF CONNECTION LENGTH FROM
SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.L. M.L.TO P.L.
PITS AND/DR DRAINFIELD @ $3.00
OVERFLOW SEEPAGE PIT,DRAINFIELD
EXTN.,CESSPOOL. DRYWELL @ $2.00
HOUSE SEWER CONNECTING TO P.C.NO. 0
P RIVATE DISPOSAL SYSTEM @ $1.00 .LO.iAM�I7� Joe-HTT
CONNECT ADDITIONAL BLDG.OR
WORK TO HOUSE SEWER @ $1.00 TRUNK PERMIT N0. ROAD PERMIT N0.
_ i
SEWER OR D SPOSFABANDON
SYSTEM HOUSE @ $1 00 STATE ENCROACHMENT
PERMIT NO.
INDUSTRIAL
WASTE APPROVAL
CHARGES >T
�D
OWNERS PERMIT $ 2 00 CONNECTION CHARGE FEE �"v Qe� � -✓�r/�
AUTHORIZATION TOTAL. FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- -
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING i{ APPROVALS ' 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
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALT ER,REPAIR.SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AM PROPS Y REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REOUIRED BY LOS ANGEL COUNTY AND STATE OF DISCONNECT
PLUGAHOUSE D
CALIFORNIA OR T 1 AM HE LE WNE F THE ABOVE
DESCRIBED REST N AL PR RTY. BACKFILL SEPTIC TANKS ❑
SIGNA E SEEP.PIT(S) [:1 CESSPOOLS ❑
OF E ITTE
®' - TION ROBERT A. WOOD
/ .o. GSH SUPERVISING MECHANICAL ENGINEER
1 717 JAH 1 S 8 1 0 3 Ci 0.0 G t:
24650 li, zJ
CE8O8
Teasnz0D50 APPLICATION FOR PERMIT - 1
COUNTY OF LOS ANGELESi.
SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER -
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
JOHN A. LAMBIE, County Enginoor
WILLIAM A. JENSEN, Supt of Building LOCALITY
_.: . . . . ........ ..
NEARESTi ✓' ,
a FOR APPLICANT TO FILL IN caoss sr.
i
LEGAL f _ -OWNER
DESCRIPTION LOT N0.
MAIL
BLOCK TRACT ✓i 4 ADDRESS92 L� je,
0.OF SLOGS. - -
SIZE OF LOT NOW ON LOT CITY 1 TEL. NO.
USE OF
BUILDINGS DISTRICT N0. GRpuP BK MAP PG PROCESSED BY
� .O (/I_ I
CONTRACTOR ,M
ADDRESS ' .T ��.' CON CTI N DATA >
CITY �(.�yL EL.N0. im '_ STATION a DEPTH
[] STATE MANHOLE REFERENCE PER
REGISTRATION NO. LJ COUNTY
No. DESCRIPTION'OF-WORK FEE '
HOUSE SEWER CONNECTING TO > 1-14
PUSLIC SEWER @ $3.00 TYPE OF CONNECTION LENGTH FROM V
PITS AND/OR DRAEINSEPTIC TANK. FIELDT OR @ $3.00 CURB P.L. M.L.TO P.L.
OVERFLOW SEEPAGE PIT.GRAINFIELD
EXTN..CESSPOOL. D RYWELL @ $2.00
HOUSE SEWER CONNECTING TOP.C.N0.
PRIVATE DISPOSAL SYSTEM @ $1.00JOB Np. 0.
CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT N0. -� Cl
WORK TO HOUSE SEWER SI.00
@ _.
ALTER,REPAIR OR ABANDON HOUSE STATE ENCROACHMEN r
SEWER OR DISPOSAL SYSTEM @ $1.00 PERMIT NO. �/ /1. 7 "
INDUSTRIAL
WASTE APPROVAL W
a
-4-CHARZAS v
M
OWNER'S PEIiMI7 $ Q 00 CONNECTION CHARGE FEE y
AUTHORIZATION TOTAL FEE U J REIMBURSEMENT FEE —/r, f
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED-CON- I G'Ll i
TRACTOR TO CONNECTTHE ABOVE DESCRIBED EXISTING DWELLING APPROVALS - DATE INSPECTOR S SIGNATU E
TO THE PUBLIC SEWER.
SIGNED THIS DAY OF IB_ NEW HOUSE SEWER
OWNER OR �� ✓c` I CONNECT ADDITIONAL a/
OWNERS AGENT ,(�� BUILDING OR WORK
ADDRESS SEPTIC TANK,SEEP.PIT(S)
AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE_THAT IHAVE READ THIS APPLICATION - ..
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL Cl DRYWELL ❑
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 ABANDON HOUSE SEWER
CALIFORNIA OR THAJ, AM THE LEGAL WNER OF THE ABOVE
DESCRIBED RESIDE AL OPER BACKFILL SEPTIC TANKS ❑
SIGNATURE SEEP. PITS) ❑ CESSPOOLS Cl
OF PERMITTE ,,rte
Or VALIDATION ROBERT A. WOOD
K.
CM.0. vsH SUPERVISING MECHANICAL ENGINEER
l (01 2 5 4 JAW 1 1 0 D 5.00 °