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HomeMy Public PortalAbout5021 GLICKMAN AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1 j' (DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION I COUNTY OF LOS ANGELES I WILLIAM J. FOX, COUf4TY ENGINEER J BUILDING �C,9 �9� CASSATT D. GRIFFIN, SUPT OF BUILDING I ADDRESS [�. R P LICANT TO FILL IN LOCALITY BUILDING EAREST ADDRESS.%L, - . (;1-(;1- IC � CROSS ST. _�- 'e-? LOCALITY 7,5.j-4 R,4 E C 7-11 DISTRICT NO. /SERIAL-�NNO. PERMIT NO. NEAREST LA A �lJ �/ �J�� CROSS ST. e ^ �+ RECEIVED BY Ready for Inspection DATE ISSUED OWNER fg, IV MAIL ADDRESS (�,L VYSEZONE OCCUPANCY BK MAP PG CITY - CONTRACTOR .99 /J.S. 7^o A?�� CHARGES REIMBURSEMENT FEE [ ADDRESS 922 NO. ENk0INITA AVE, REQUIRED NOT REQUIREO-"""y-- - ~� CITY TEMPLE CITy TEL.NA`r- 6- A SOB.NO. "" CONNECTION CHARGE FEE ` STATE ,qq REGISTRATION NO. 2 / COUNTY CO.IMP.NO. LEGALfRECEIPT N0. DATE I BY DESCRIPTION LOT N0.4G9 rCdr [Q�/ ---- ---=-- - -- BLOCK TRACT F_.�', (5,4j_A W/IVS 04,0 WAIYER.FOR=RECORDING_ SIZE OF LOTNO.OF BLDGS. NOW ON LOT RECEIPT NO_ - _ DATE._____, I BY USE OF BUILDINGS 7?6g/GL 16 ATC rt S TRUNK PERMIT NO. — -~ - NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO ROAD PERMIT NO. ��1} �(� PUBLIC SEWER @ $ 3.50 ,� P HOUSE SEWER CONNECTING TO STATE ENCROACHMENT PRIVATE DISPOSALSYSTEM 1.00 PERMIT N0. CONNECT ADDITIONAL BLDG.OR INDUSTRIAL WORK TO HOUSE SEWER 1.00 WASTE APPROVAL ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1.00 CONNECTION DATA DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 STATION J ' DEPTH C� b SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 MANHOLE REFS ENCE„ CESSPOOL—DRYWELL UPPER f �"�/� �� LOWER !✓ ��/�/�( .- SPECIAL CONDITIONS ONLY 2.00 I� TYP�OF CONNECTION LENGTH FfgQM-� Y� CURB OWNERS PERMIT ; 1 00 AUTHORIZATION TOTAL FEE IHAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE q SIGNED THIS-----+G 7 DAY OF- �� L / 19'��3 NEW HOUSE SEWER F^�l( �.< 1;� I;��;J7 OWNER OR CONNECT ADDITIONAL OWNERS AGEN -•--- BUILDING OR WORT( ADDRESS_/-f.'r_ _4SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I A A THIS ADPL- CESSPOOL F] DRYWELL CAT ICN AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR SEWER REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I A HE LEGAL OWN ER OF THE ABOVE DPGJIIBED RESID AL PROPERTY BACKFILL SEPTIC TANKS / SIGNATURE ,�/p SEEP.PIT(S) CESSPOOLS j OF PERMITTEE__-______ �f•-•• a 76A642D 663 12/52 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 v F © PyC IT —Fl INLOCALITY BUILDINGNEAREST ADDRESS �L CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST A S CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED OWNER MAIL „y0 �' USE ZONE OCCUPANCY MAP 12 ADDRESS "aI I I BK PG CITY TEL.NO. CONTRACTOR CO.IMP.NO. , ADDRESS JOB.NO. CITY TEL.NO. _LFtU ❑ STATE REGISTRATION NO. ❑ COUNTY ROAD PERMIT NO. LEGAL DESCRIPTION LOT N0. STATE ENCROACHMENT ERMIT NO, BLOCK TRACT / MDUSTRIAL WASTE APPROVAL SIZE OF LOT 0.OF BLOCS. OW ON LOT CHARGES USE OF BUILDINGS Ao CONNECTION CHARGE FEE NO. DES IPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $ 3.50 RECEIPT NO. I DATE IBY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR )i EXCEPTION RECORDED 1 WORK TO HOUSE SEWER 1.00 f ALTER OR REPAIR EXISTING NO- I DATE (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 DRAIN_FIELD 2.00 STATION r DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 I /!�'b �Y' MANHOLE REFERENCE UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT $ 1 I 00 Y. CURB P.L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED E (STING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO T PU IC SEWE/R��f. n Q SIGNED THIS.- ...D OF-'!'_ .. •___I sl NEW HOUSE SEWER OWNEROR CONNECT ADDITIONAL OWNERS A T BUILDING OR WORK SEP IC TANK,SEEP.PIT(S) ADDRESS.. ...... ....... A /ORD RAINFIELD 1 HEREBTAQ&AOMTL'E9GE THAT 1 HAVE ft&D THIS A SSPOOL❑ DRYWELL 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 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES N i / S COUNTY AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN. ABANDON HOUSE SEWER ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFI LL SEPTIC TANKS E] SIGNATURE SEEP.PIT(S)❑ CESSPOOLS OFPERMITTEE----------------------------•-----------------•------------------------ 76A642D 663 1/53 DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS LI T OU IN LOCALITY BUILDING NEAREST ADDRESS CROSS ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST {_ A 5 CROSS ST. fes' RECEIVED BY Ready for Inspection DATE ISSUED OWNER Lim Aeu� MAIL USE ZONE OCCUPANCY MAP y ADDRESS I I BK PG CITY TEL.NO. CONTRACTOR CO.IMP.N0. ADDRESS JOB.N0. CITY TEL.NO. TRUNK PERMIT N0. ❑ STATE REGISTRATION NO. E] COUNTY ROAD PERMIT NO. LEGAL DESCRIPTION LOT NO. STATE ENCROACHMENT / /y"�-/, * PERMIT NO. BLOCK TRACT I - INDUSTRIAL WASTE APPROVAL SIZE OF LOT N0.OF BLDGS. 0 ON LOT CHARGES USE OF ,Q, BUILDINGS '� � l CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO __PUBLIC SEWER 4D $ 3.50 RECEIPT NO. I DATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 J NO ALTER OR REPAIR EXISTING 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/OR DRAINFIELD 2.00 STATIONDEPTH CESSPOOL—DRYWELL P SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE UPPER _.. - LOWER TYPE OF CONNECTION LENGTH f.R" Y. CURB F P.L. -M.L.TO- L. OWNERS PERMIT � � I 00 AUTHORIZATION I TOTAL FEE 1 Z O 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TORE PUBLIC SEWER ,��� SIGNED THIS - DAY OF..�Q'�'_.... ..19!! NEW HOUSE SEWER OWNER OR 'y,l CONNECT ADDITIONAL �A!l�—v— BUILDING OR WORK OWNERS AGod ---- - - IC TANKSEEP. ADDRESS- -- ---- -- - - -- ­.-. ^ - SE /ORDRAINFIELDIT(S) 1 HEREBY A KNO EDGE THAT I HAVE D THIS AP CESSPOOL(] DRYWELL 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 CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS SIGNATURE SEEP.PIT(S)Ej CESSPOOLS❑ OFPERMITTEE--------------------------------------------------------------------------- 76A642D 663 1/53