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Home My Public Portal About10770 FAIRVIEW AVE_Sewer__ , D 5&E-669 i1.5S APPLICATION FOR PERMIT ' 1 3&E.6 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING JOHN A LAMBIE. COUNTY ENGINEER ADDRESS ® CASSATT D GRIFFIN, SUP T of BUILDING LOCALITY �` FOR APPLICANT TO FILL IN CROSS ST LEGAL DESCRIPTION LOT NO MAIL - - BLOCK (,J TRACT ADDRESS NO OF BLDGS CITY TEL NO SIZE OF LOT NOW ON LOT USE OF DISTRICT NO GROUP MAP BUILDINGS CONTRACTORoa d / C10, K f� ADDRESS.��f/ ,�_ ,� /��J CONNECTION DATA CITY 7TEL NO �t 1STATION / Y DEPTH MANHOLE REFERENCE Q UPPER T REGISTRATION NO / .38 ❑ COUTY V NO DESCRIPTION OF WORK FEE TYPE OF CONNECTIO LENGTH FROM HOUSE SEWER CONNECTING TO �O Y. CURB P L M L TO P L PUBLIC SEWER @ $3 50 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 NO JOB NO HOUSE SEWER CONNECTING TO . PRIVATE DISPOSAL SYSTEM @ $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 @ $1 00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE I ISO I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS- DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING / ��r ✓ TO THE PUBLIC SEWER � ��/ NEW HOUSE SEWER SIGNED THI ,v D OF 19—L CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENTSEPTIC TANK,SEEP,PIT(S) ADDRESS ' �grAND/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 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE JOHN A LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CK 61 0 CASH UTZQ 1-0 E co JAN 6 4- A 4.5-0 9 DEPAIVrMENT OF COUNTY ENGINEER SEINER-SEWAGE DISPOSAL 7 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION ,l COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING - ] ADDRESS /D O � / b (� / ✓ (,(� FOR APPLICANT TO FILL IN LOCALITY „n r BUILDING ADDRESS /r/ (/ ! 7 /") AA �.W I�.. CROSS ST S / Mp Q LOCALITY Ir` NEAREST 7' DISTRICT NO SERIAL NO. PERMIT NO ,^ y) L� /Al M ® � P A �'i� /' S CROSS ST f/ /` h (e RECEIVED BY Ready for Inspection DATE ISSUED OWNER , ^4 L 7- 7 A4/3MAIL ADDRESS ,� �Q �� USE ZONE OCCUPANCY MAP . I I BK PG CITY P/ V,&.1 CONTRACTOR CDC�� ®i+ 4D/&3ixA%(L�� SllP'r�1 AG ' CO.IMP NO ADDRESS �1 l �� JOB NO CITY r GAJ TELAO. TRUNK PERMIT NO. STATE - REGISTRATION NO L� �/� COUNTY ROAD PERMIT N0. LEGAL DESCRIPTION LOT NO STATE ENCROACHMENT _PERMIT NO BLOCK TRACT INDUSTRIAL SIZE OF LOT NO OF BLDGS. WASTE APPROVAL NOW ON LOOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE PUBLIC SEWER @ $ 3.50 RECEIPT NO DATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING NO I DATE I BY SEWER OR DISPOSAL SYSTEM 1 00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA SEPTIC TANK.SEEPAGE PIT OR PITS AND/ORDRAINFIELD 2.00 _ STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 200 MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT ; I 00 Y. CURB P.L. M L TO P L - AUTHORIZATION TOTAL FEE q_ r'�- I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER .� SIGNED THIS-_1._C_......DAY OF----/ f A_.V...............191:? NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL v/tiy O W N ERS AGENT------------------------------------------------.-------------- -__ BUILDING OR WORK Y ADDRESS.. ... .---------_..--- -----_ ------------------- ---••-------------------- SEPTIC TANK,SEEP.PIT(S)AND/ORDRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS JRE CESSPOOL❑ DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND TO COMPLY WITH ALL COUNTY ORDINANCES AND STATEALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISDISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES C AND STATE OF CALIFORNIA OR THAT I AM THE LEGALABANDON HOUSE SEWER ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTBACKFILL SEPTIC TANKS SIGNATURE SEEP PIT(S)E] CESSPOOLS OF PERMITTEE 76A642D 663 1/53