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Home My Public Portal About4827 GLICKMAN AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER I BUILDING ADDRESS l FOR APPLICANT,TO LL IN LOCALITY BUILDING !/� NEAREST ADDRESS J� / �y� int.` CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST A S C CROSS ST. - RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL USE ZONE OCCUPANCY MAP ADDRESS I I BK PG CITY TEL.NO.<6 k1jej2 CONTRACTOR CO.IMP.N0. ADDRESS JOB.NO. CITY TEL.NO. G� TRUNK PERMIT NO. VSTATE REGISTRATION 0. ❑ COUNTY ROAD PERMIT NO. LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT / PERMIT NO. BLOCKDUSTRIAL /-f TRACT f® WASTE APPROVAL SIZE OF LOT NO.OF BLOGS. NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF W K FEE REIMBURSEMENT FEE / HOUSE SEWER CONNECTING TO PUBLIC SEWER f 3.50 C RECEIPT NO. i DATE I BY HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM1.00 CLONNECT ADDITIONABLDG.OR I EXCEPTION RECORDED WORK TO HOUSE SEWER I.00 ALTER NO.OR REPAIR EXISTING I DATE I BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 I CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 I STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER AW=a TYPE OF CONNECTION LENGTH FROM £ OWNERS PERMIT $ I 1 00 X CURB Vq --.._ M.L.TO P.L. L AUTHORIZATION I TOTAL FEE -� fi^ — 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----,,.®------DAY OF....... ...___.._.. ........... 19 5_X NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT ..._ ._..-...... BUILDING OR WORK c- SEPTIC TANK,SEEP.PIT(S) ADDRESS..-` .- - - Z1l4rZG9_`_;1. t?¢eL�c' AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL E] DRYWELL E]CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY D l THAW I_ AM PROPERLY REGISTERED DISCONNECT PLUG AND ❑ AND/OR ! SED_AS'REO (fR TWAT,LOS ANGELES COU TY ABANDON HOUSE SEWER AND STA E CALIFORNI OR THATlI AM,,iiJfE LEGAL N- ER OF T B VE'BfBCRI ED_,$fS10EllTikC PROPFRT �� BACKFILL SEPTIC TANKS SIGN ATI� r SEEP.PIT(S)❑ CESSPOOLS OF PER fkIE. --- ---•-•--- - •---. - ._._..._.__.. 76A642D 663�_l�: 53 6A642-62 7 D APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN. Supt of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL - — _ -- - DESCRIPTION LOT NO. OWNER MAIL BLOCKAt TRACT ADDRESS OF BLDGS. O. SIZE OF LOT W ON LOT CITT' G TEL. NO. USE OF DISTRICT NO. GROUP MAP CESSED BY BUILDINGS O BK PG CONTRACTOR Cp 1 1 ADDRESS , CONNECTION DATA CITY T L. NO. STATION DEPTH ❑ STATE MANHOLE REFERENCE l UPPER REG ISTRATIOV NO. ❑ COUNTY O7 NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $5.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR CO.IMP.NO. JOB NO. V PITS AND/OR DRAINFIELD @ $10.00 HOUSE SEWER CONNECTING TO T N ROAD PERMIT NO. n' PRIVATE DISPOSAL SYSTEM @ $3.00 OF CONNECT ADDITIONAL BLDG.OR FFIDAVI WAIVER EASEMENT jjCORD.INSTR.NO, DATE WORK TO HOUSE SEWER @ $3.00 3 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL.DRYWELL,MANHOLE @ $5.00 HWY.OR ST.WIDENING ""��" 'BANDON HOUSE SSSrrr_ SEWER @ $3.00 �• STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNER'S PERMIT $ 21 00 CHARGES AUTHORIZATION TOTAL FEE DLJ CONNECTION CHARGE FEE 1 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'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP,PIT(S) D1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND S TE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OFLEGAL OWNER OF' AND END TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE SL;RIB ESIDENTIAL PROP ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ElF PERMITTEE SEEP,PITS) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER GK. M.O. CASH L;j)01 J 2 4 Q0 FEB i t a, C .'u '.l J -62 76A642D APPLICATION FOR PERMIT 6A642 �JJ COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING /J 1OlfIQ A. LAMBIE, Comity Engineer ADDRESS y WILLIAM A. JENSEN. Sup't of Building LOCALITY NEARESTdor FBUILDINGS R APPLICANT TO FII.L IN CROSS ST. L U LOT NO. OWNER MAIL TRACT ?� ADDRESS OF BLDGS. NOW ON LOT CITY TEL. NO. // DISTRICT NO. GROUP MAP PROCESSED BY BK PG CONTRACTOR ADDRESS �� TT . CONNECTION DATA CITYEL. NO.7,$o'/ •/ ATION REGISTRATION NO. �.3d'�¢ COUNTY MANHOLE REFERENCE XOT ( PPE NO. DESCRIPTION OF WORK FEE TYPE OF CONNE TI LENGTH FROM /, } HOUSE SEWER CONNECTING TO Y. CU P.L. M.L.TO P.L. (� PUBLIC SEWER @ $5.00 O P.C.NO. SEPTIC TANK,SEEPAGE PIT OR CO.IMP.NO. JOB NO. UPITS AND/OR GRAINFIELD @ $10.00 - HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 `� O CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER EASEMENT RECORD. INSTR.NO. DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN.,CESSPOOL.DRYWELL.MANHOLE Q $5.00 HWY.OR ST.WIDENING ALTER.REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT $ 2 OO CHARGES AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN MED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTI G DWELLING - -- TO THE PUBLIC SEWER. APPROVALS FAT9 INSPECTOR'S SIGNATURE I SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL / J' ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PITS) 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 ElDRYWELL El 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 LLAM THE LEGAL OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THEDESCRIB D DE L PROPERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE -- SEEP.PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER K. M.O. CASH ': n CEIIOB -62 76A642D APPLICATION FOR PERMIT 6A642 �1 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN. Sup't of Building ` LOCALITY NEAREST FOR APPLICANT TO FILL IN CRDBB ST. LEGAL DESCRIPTION LOT NO. OWNERe �,R' MAIL BLOCK a TRACT ADDRESS OF BLDG S. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS - BK PG CONTRACTOR �- I a 6 l � ADDRESS �� 0¢ r - CONNECTION DATA S ATION DEPTH CITY TEL. NO Z REGISTRATION NO. ��. , COUNTY MANHOLE REFERENCE PPER NO. DESCRIPTION OF WORK FEE TYPE OF CO N N LENGTH FROM HOUSE SEWER CONNECTING TO Y. P.L. M.L.TO P.L. 3ru PUBLIC SEWER @ S5.00 SEPTIC TANK.SEEPAGE PIT OR CO.IMP.NO. 3 JOB NO. P.C.NO. V PITS AND/OR DRAINFIELD @ $IO.00 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. O PRIVATE DISPOSAL SYSTEM @ $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT I WAIVER I EASEMENT RECORD,INSTR.NO, DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $5.00 HWY.OR ST.WIDENING ALTER.REPAIR OR ABANDO SE -. SEWER OR DISPOSAL S @ S3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERCHARGESS PERMIT $ AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE 1 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'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 COUNTY ORDINANCES 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 AM THE LEGA NER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE AB E DESURI D SIDE IAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS T ❑ OF PERMITTEE SEEP.PIS) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD M.O. CASH SUPERVISING MECHANICAL ENGINEER CK t..r� t rip 3 U 7�� n �. '� J 1 YL