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HomeMy Public PortalAbout5327 FRATUS DR_Sewer__ 762 76A64262 APPLICATION FOR PERMIT � -��-7 6A642 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBLE, County Engineer ADDREss�� WILLIAM A JENSEN, Sup t of Buildmg LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST LEGAL DESCRIPTION LOT NO alma OWNER MAIL BLOCK TRACT ADDRESS S� NO OF SLOGS T ;PROCESSED SIZE OF LOT NOW ON LOT CITY ` TEL NO o USE OF DISTRICT NO �Tj MAP BYBUILDINGS ' BK PG CONTRACTOR 0 D� ! ADORES CONNECTION DATA CI TEL NO � ,O S ON DEPTH / ��ATE MANHOLE REFERENCE REGISTRATION NO `_ El COUNTY LOWER NO DESCRIPTION OF WORK FEETYP OF CO EC O LENGTH OM HOUSE SEWER CONNECTING TO Y R L M L TO PUBLIC SEWER @ S5 00 6',PO- C NO SEPTIC TANK SEEPAGE PIT OR J VVVI' PITS AND/OR DRAINFIELD @ 510 00 CO IMP NO OB NO d HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ 5300 CONNECT ADDITIONAL BLDG OR AFFIDAVIT wA1VER [ASEM[Xi RECORD INSTR NO DATE WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @ S500 ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING SEWER OR DISPOSAL SYSTEM @ $300 STATE ENCROACHMENT PERMIT NO INDUSTRIAL ♦y/, WASTE APPROVAL r CHARGES OWNERSPERMIT S 2 00 AUTHORIZATION TOTAL FEE /I.0 CONNECTION CHARGE FEE 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT TH OVE DESCRIBED EXISTING WELLING TO THE PUBLIC SEWE APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS AY OF V Q 79 OWNER OR �/ NEW HOUSE SEWER OWNERS A E CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP PIT(S) I HEREBY ACKNOWLEDGE THAT 1 H VE READ THI AP ICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREkE yb COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS EGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ 1 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 M THE GAL OWNER LID INTEND TO ISCONNECT PLUG ANRESIDE IN THE ABO DESCRI D RESIENT AERTY ABANDON HOUSE SEWER SIGNATURE �-� !/Q�_/�I(nil BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP PIIS S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A WOOD CK M O CAS C. ' SUPERVISING MECHANICAL ENGINEER Lhbo 1 g ��i.,R E3 o a _/.O n- �: 62 76A64262 APPLICATION FOR PERM 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL ILII DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �j A•CV� ✓w AY JOHN A LAMBIE County Engineer ADDRESS I WILLIAM A JENSEN Sup t of Building / LOCALITY NEAREST FOR APPLICANT TO FILL IN cROss sT LEGAL 71, DESCRIPTION LOT NO Y��" B �D �� OWNER MAIL BLOCK A TRACT / ADDRESS / jA GyLP�r.+ r�±Yn �-4 � � /) SIZE OF LOTG d^ 4J NOWOON LOTS • CITY r TEL NO USE OF BUILDINGS DI�STR/IjCiT NO GRO MAP PROCESSED BY SK PG CONTRACTOR /1 u�,�j N y A /,V 1,_D ' :tom 14 ADDRESS Z(vTWl- -7 G ST, �J CONNECTION DATA CITY / (s / TEL NO ..-j- a 3/ / STATION DEPTH ❑ STATE MANHOLE EFERENCE _ UPPER REGISTRATION NO ❑ COUNTY LOWER NO DESCRIPTION OF WORK FEE TYPE OF ECTION LENGTH FROM �. HOUSE SEWER CONNECTING TO Y CUR PSC M L TO P L O PUBLIC SEWER @ $500 PC NO r' SEPTIC TANK SEEPAGE PIT OR CO IMP NO OB NO V PITS AND/OR DRAINFIELD @ 51000 HOUSE SEWER CONNECTING TO TRU ERMMITIT NO ROAD PERNO PRIVATE DISPOSAL SYSTEM @ $300 _ 0 CONNECT ADDITIONAL BLDG OR AFFIDAVIT wAW EASEMENT RECORD INSTR NO D T-6_ WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYW ELL MANHOLE @ $S 00 ABANDON HOUSE HWY OR ST WIDENING 4_ DISPOSAL SYSTEM @ $300 I STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS I PERMIT $ 21 00 AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEW R APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF 19_ 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 F-1 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 v CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND ( / RESIDE IN THE AB E DESCRIBED RESIDENTIAL PROPERTY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTE SEEP PIT(S) ❑ CESSPOOLS El VALIDATION ROBERT A WOOD (Y) M O CASH SUPERVISING MECHANICAL ENGINEER CK 0 8 7 1`0 FEB 13 1 0 D 5.0 0- i�� 62 76A64262 APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER-SEWAGE DISP SAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �a JOHN A LAMBIE, County Engineer ADDRESS V WILLIAM A JENSEN Sup t of Building LOCALITY NEAREST FOR APPLICANT TO L `ROSS ST LEGAL DESCRIPTION LOT N OWNER MAIL BLOCK TRACT ADDRESS NO OF BL GS SIZE OF LOT NOW ON LOT CITY TEL NO USE OF DISTRICANO GROUP MAP PROCESSED BY BUILDINGS ` L..1• BK � CONTRALTO /� � V � © ADDRESSjg�Vfol� CONNECTION DAT tffN DEPTH CI EL N Q ❑ STATE MANHOLE REFERENCE REGISTRATION NO ❑ COUNTY O LOWER NO DESCRIPTION OF WORK FEE TY OF CON CT LEN TH FRO HOUSE SEWER CONNECTING TO Y P M L TO P L PUBLIC SEWER @ $5 00 PC NO SEPTIC TANK SEEPAGE PIT OR JOB NO V PITS AND/OR DRAINFIELD @ $1000 CO IMP NO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ $300 CONNECT ADDITIONAL BLDG OR AFFIDAVIT I WAIVER EASE MERr RECORD INSTR NO DATff WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT DRAINFIELD EXT N CESSPOOL DRYWELL MANHOLE @ $5 00 ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING S R DSPO L EM @ $300 STATE ENCROACHMENT C" PERMIT NO INDUSTRIAL WASTE APPROVAL 4l OWNERS PERMIT $ CHARGES AUTHORIZATION I TOTAL FEE CONNECTION CHARGE FEE 1HAVE 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 S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP PIT(S) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTYORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ IHEREBY 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 M THE EGAL OWNER OF ND INTEND TO DISCONNECT PLUG AND RESIDE IN THE ABO DESI�STIAL OPE RTYOPE RTY , ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A WOOD CK M O CASH SUPERVISING MECHANICAL ENGINEER 3 --' 20 i L,JI 3 1 1 D 2 5.-,,,0