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Home My Public Portal About9522 GIDLEY ST_Sewer__ C I /L/ I G - .n g p t k �:��' },jr H.q+ z s DEP R12kDENT OF OOUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1 DMSION OF BUILDING AND SAFETY PERMIT APPLICATION OOUNW OF LO$ ANGELES WILLIAM J. FOX. COUNTY ENOINEER BUILDING _ ADDRESS _fOR APPLIPANT TO RLL IN LOCALITY BUILDING S' �' /e C OSSB�r . ADDRESS LOCALITY �� DISTRICT NO. SERIAL NO. PERMIT NO. c NEAREBT A 5 S CR088 ST. TJ7T b e C; �. / EOEIVED BY Raaf for laaptatio■ DATE ISSUED OWNER !'Ar�'Pd� .�u_rralsfr�In- --"' MAIL IUiEZOto OCCUPANCY YAP ADDRESS l � BK PO CITY TEtLNO. ,?// / —'� � ( `}^ L— CONTRACTOR `• dr& 6r r A C CO.IMP.NO. ADDRESS s 7> /f e JOB N0. CITYva✓��P TELNO. TRUNK PERMIT NO. REGISTRATION N0. gq (� COUNTY ROAD PERMIT N0. LEGAL DESCRIPTION LOT N0. (y e Yz. STATE ENCROACHMENT � l PERMIT NO. BLOCK TRACT INDUSTRIAL " C WASTE APPROVAL SIZE OF LOTN0.OF BLDGS. Z CHARGES —Z X NOW ON LOT USE OF BUILDINGS S CONNECTION GEFEE NO. DESCRIPTION ❑F WORK FE ' REIMBURSEMENT FH[ HOUSE SEWER GONNCnNO PUBLIC SEWER - 0 $ am 3 �`O RECEIPT NO. BY HOUSE SEWER 0ONNEV11WO TO PRIVATE DISPOBAL SYSTEM 1.00 OONI BLD6.OF EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER ah kEPA1NG NO' DATE BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM Loo CONNEC11ON DATA SERTICTANB Pit PITS AMD OR DRAINFIELD 2M STATION DEPTH CI SPECIAL CONDITIONS ONLY Lw Y IiHA E EFERENC[ PE OF OONNECTIO UPP LENGTH FRONS OWNERS PEWIT $ 1 Y •-Ci1Ja Com+ M.L.TO P.L. AUTI-IORaATION TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPEOTOR'SSIGNATURE DATE DWELLING TO THE PUBLIO SEWER ` C/ S16NED THIS 2—DAY OF 19�T NEW HOUSE SEWER C r "', `¢ OWNER OR CONNECT ADDITIONAL OWNERS ADEN BUILDING OR WORK VXYICDDRESS I SEPTO TANK.BEEP.PIT(8) AMD R DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[-] DRYWELL Ej CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR W SEER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AY PROPERLY REGISTERED DISCONNECT PLUG AND AMD/OR LIOENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND AND STATE OF CALIFORNIA OR THAT I AN THE LEGAL OWN- USE SEWER ER OF THEA VE�DESONIBED BESJIDENTIAL PROPERTY. aAOkFiLL IFPTIO TAM OIGNATURfi / .II� SEEP.PIT(S)� CEiBP00L� e' OF PERINITTE TGABUA 60 T/62 1 APPLICATION. FOR PERMIT DrlfMON OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL D.pxaww-nt of Commf7 En;bm«e Co=iy of Los Anga" FAD INa JOHN A. LAMBIE, CouNTY ENGINEER ESSm CABBATT D.GRIFFIN, SUPT of BuiLmma LITYFOO APP TO FILL IN Rs'ir �L c LEGAL OWNER DESCRIPTION - LOT N0. MAIL BLOCK TRACT ADDRESS - 0. OF SLOGS. CITY TEL. NO. SIZE OF LOT NOW ON LOT - UI OFLDINGS C BDISTRICT N0. GROUP YAP BUIF+ •�^ BK PO CONTRACTOR CONNECTION DATA STATION DEPTH CITY TEL N0. MANHOLE REFERENCE . UPPER tl'3TATE LOWER REGISTRATION No. 15,2 ❑ COUNTY NO. 1 DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTI LENGTH FROM Y. CURB .L. Y.L.TO P.L. PUBLIC SEWER 4R s].SO SEPTTC TANK,BEEPAtE PIT OR PITS AND/OR DRAINFIELD 3.00 OVERFLOW SEEPAGE PIT,DRA"(FIELD N0. HZTX.,CESBPOOL DRYWELL MANHOLE 2.00 CO. IMP. N0. JO O. HOUSE ITWEACONNECTING:TO PRIM TE DISPOSAL SYSTEM @ $1.00 TRUNK PqZMrr mg. ROAD MIT NO. vj CON-XECT ADDITLONAL BLDG.OR ET//.�TY H}(CAOACHYEX - ' WORK TO HOUSE SEVER e S1.00 pBSiY X0. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM B 1.00 WASTE APPROVAL ' C HAR G ES CONNECTION CHARGE FEE OWNER'S PERM' i 1 00 AUTHORIZATION TOTAL. FUREIYBUASEYEXT FEE' d I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DA-Tri INSPECTOR•SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED E"'TING DWELLING TO THE PUBLIC SEWER. NHW HOUSE SEVER f SIGNED THIS SAY OF 19 CONNECT ADDITIONAL OWNER OR y/ BUILDING OR WORK OWNERS AGENT `- w REPTIC TANK,BEEP,PIT(5) LDDS AILD/OR DRAINFIELD EBY ACKNOWL.EDGF THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ATE THAT THE ABOVE IS CORRECT AXD AGREE TO COMPLYLL COUNTY ORDINANCESAND STATE LAWS REGULATING ALT¢,REPAIR,SEWER OR NG AND SEWERS. SEWAGE DISPOSAL SYSTEM EBY CERTIFY THAT I A■ PROPERLY REGISTERED AND/OR D16CDNNECT PLUG AXD RD AB REQUIRED BY L S AH'9ELEE OOUNTY AND STATE OF ABANDON HOUEEEEYER RNIA OR THAT 1 A HE LEGAL NER OF THE ABOVEBED RESIDENTIAL ER TY. BACKFILL SEPTIC TANKS❑LRE ESEP•PIT S ❑ QFSSPOOL�❑ RMITTEE JOHN A. LAMBIE. C ENGINEER VALIDATION ROBERT A.WOOD, CHI¢PLI30. INoPECTOR cr ■.0. CASH �I 9571 JM .;L 4- 4 - 2.00 to 76A 64ZO-CE808—10-71 APPLI C ION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENOINEER BUILDING AND SAFETY DIVISION 1111LDINa r� t ADDRESS ` LOCALITY FOk APPLICANT TO FILL IN NEAREST CR OSI aT. }+ OAL DESCRIPTION LOT NO. OWNER L� MAIL � BLOCK TRACT ADDRESS NO. OF BLDGa. /+ SIZE OF LOT NOW ON OT CITY NO. USE OF DISTRICT NO. UP MAP 6Sl ED Y BUILDINGS BK Pi ao NT7tACT p / ADOR CONNECTION DlITA CITY NO. ATION DEPT STATE LIC // M'A PL[REFERENCE UPPP LIC[N■[ NO Ct ASS LOWER No. I • .BESCRIFMON OF WORK FII TY bF CONNECTIO!{ LENGTH FROM HOUSE■EWER CONNECTiNG TO Y. CUR d- r.i M.L.TO P,L PUBLIC■I W[R $7.00 P.C.NO. ■ PTIC TANK,1 GE PIT OR CO.IMP.NO. J01%NO. ' PIT■AND/Oft DRAINFIELD SI0.00 HOUSE S[W[R CONNECTING TO TRUNK PERMIT NO. MIT NO, a PRIVATK DISPOSAL SYSTIM 57.00 O CONNECT ADDITIONAL BLDG.OR AF-FIDAVIT &Ml -Wul[[T R[CORD.INSTR.H DATE (J WORK TO HOVSK SEWER 4E.00 OVERFLOW SEEPAGE PIT.DRAINFIELD cc SKTN..C[SSPOOL,DRYWKLL [8.00 O A LaSopombpokWOmow ABA N DO O U&E HWY. OR ST.WIDENING ■EWER 0 ■5.00 ■TAT;ENCJtOAGHM[NT MAN 0 $7.00 PERMIT NO. N INDUSTRIAL Z WAST[APPROVAL C'HARO[S WNEH'S PEHDSTT s a 00• AUTFIOEPLATION I TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH TH[ H[R[IN NAMED CONS REIMBUR■[M[NT FEE TRACTOR TO CON N[CT THE ABOVE DESCRIBED U(IBTING DWELLING �[T�� RTS To THE PUBLIC SEWER. APPROVALS bATR INSPECTOR'S 61GNATU R[ SIGNED THIS DAY OF 1R— OWNER OR NEW HOUSE S[W[R OWNERS AGENT CONNECT ADDITIONAL BUILDING OR WORK ' A.ODR"s SEPTIC PUT(B) I HEREBY ACKNOWLEDGE THAT I HAVE ROAD THIS APPLIGTIOH AND/OR DRAT DAAINFIKFI[LD AND STATE THAT THE ABQVE. I■ CORRECT AND AGR[[ TO COMPLY WITH ALL COUNTY ORDINANCES AND IFTATZ LAWS REGULATING C[f■POOL DRYW[LL ❑ PLUMBING ANP SEWE". 1 HEREBY CERTIFY THAT I AM Pry OFKALY R[GI ST ERIM AND/OR ALTER,REPAIR.■[W[R OR LIC[N SEP AS REQUIRED ■Y LOS ANGLES COUNTY AND STATE [ OF ■ WAG[DISPOSAL 6 CALIFORNIA OR THAT I AM THE LEGA NEIL OF. AHD INTEND TO DISCOt/N[CT PLU A RESIDE iN, THE ASO DUCRI BED [ll NTIAL PRQP[RTY. ABANDON SIGNATURE OF P[RM BACKFILL■[ IC TA VALIDATION CK. 4.0. G■N r (' 0 6 5 5-r). nU 1 1 0 D 6.0 Q- 4