The URL can be used to link to this page

Home My Public Portal About10211 GREEN ST_Sewer__ 76,42V . } APPLICATION FOR PERMIT ihur�,OF.LOS ANGRLES SEWER EWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING 0113 SAFETY DIVISION WILDING JOHN'A. LAMBIE, COUNTY F1Va1N[[R ADDRESS COLEMAN W. JENKINS, SUP'T. OF Bu)LDhNa LOCALITY XGll FOR APPLICANT TO FlU INAL • R. O[liCRIPTION LOT ND. 2 A OWNER MAIL BLOCK 'TRACT R,LoADOltifl !� 1 NO. OF . DIXIE OF LOT �! NOW ONBI..LOT CITY T Td-. NO. T /� US[ OF [ DIST#ICT NO OROU MAP FROCElJ�D K ■SK oil OS _ D!C TNl CONTRACTOR ADC)R[S1 CONKE=ON DATA CITY TEL NO. STATION DX*7-k STATE LIC MANHOLE R[FCRWCJ[ �� LIC •E NO, CLAN No. DCB CRIPTION OF WORK FQ TYPE OF CONNECTION LEN FRO HQUBXSKWKR CONNECTING TO Y. CURB P.L M.L.TO PA_ PUBLIC SEWIER $17.00 S[PTICTA K. G[PIT DR P.C.NO. / PITT AND/OR DRAINFI[LD � •10.00 Co.JMP.No. HOUSE SEWER CONNECTJNG TO TRUNK PERMIT NO. ROAD PLRMIT NO. PR PRIVATE DISOSAL SYSTEM 1$.00 Q COl1 C7 ADDITIONAL 7ILDQ. A"IDAVIT WA"— tAEvia't RECORD.INS".NO. DATE WORK 0 HOUSE e[WtR f1.00 oYFJtFLOW SaMPAa PIT.DRAINFINE O [JCTN_CSS POOL.DRYMS[LL MA NH OLI a fS. HWY.OR ST WIDENS 0 ALTER, AIR OR ABANDONOUSEH SEWER OR DISPOSAL SYSTEM 13.00. G_I STATE"CRDACHMENT d PERMIT NO. Cn INDUSTRIAL WAST[APPROVAL O a CHARGES o PE$M r i Op AUMOETLATION I TOTAL FM CONNECTION CHARGE FEE I HAVE AT THIS DAT[ A CORTRACT WITH TH[ HER[IN 4MIED CON. REIMSURIEMENT FEE TRACTOR TO,CONMXCT THE ABOVE DESCRIBED LxitrINf1 DWELL1Na APPROVALS TO TH! PUBLIC • ER. DATE INSP[LTO R'S SI Q NATJ R[ SIGNED THIS DAY OF 147 1 OWNER OR �, NEW HOUSE SEW" OWNERS AQKKT CONNECT ADDITIONAL WILDING OR WORK ADDRES■ DEFTICND/O TANK.■ O.IKIr PIT{S) I HEREBY ACKNOWLEDGE THAT,I HAVE D THIS A IGTION A7VD�QR DAAINFI[�.D AND STATJE THAT THE ABQVE IS CORRECT AND. AGREE TO COMPLY Wf W ALL COUNTY ORDINANCES AND STATS LAWS REGULATING FLUMBINO AND SEWERS, CX"POOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERI D ANO/OltALTER.REPAIR.SEWER OR LICKP{SSD AS REOUIRlD BY LOS ANGLE• COUNTY AND STATE OF ■[)IMAGE PISPOSAL'fYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTItND TO 1•CONN ECf lLU6 AND RESIDE IN, THE ABOVE D RI BED RESIPENT1A ROP[RTY. ABANDON HOUL SEWER SIG NATURE 6ACKFILL S[P7�-�yC TANKS ❑ Ej OF FERM ■[[P,hIT{/) L1 C[SSFOOLS VALIDATION CR. ALLEN CK. M.O. SUPERVISING M ENGINEER MECHANICALENGINEERCATH t rs 2- 9 -3g AW12 1 0 ,D 00' -7 ;ems 1D ; , APPLICATION FOR PERMI NT I-OF LOS ANGELES SEWER—SEWAGE DISPOSAL DtrARTMENT-OF COUNTY ENGINEER BUILDING AND SAFeTY DIVISION ■UILDING JOHN A. LAMBIE, COUNTY ENGINKER ADD— G e Q IIIIIIIIIIIIIIIIII COLEMAN W. JENKINS, SUPT. OF BUILDING m l LOCALITYTe FOR APPLICANT TO FILL IN m KA WEST G LKQAL DESCRIPTION LOT NO. OWNER c . r MAIL /LOCK TRACT ;7,-7 3 0 ADD11W Q �' C SIZE OF LOT 7;% 1 O I maw OON LOT/ CTl' r� 1v CIT TEL. NO. USE I ll r_ ■UILDING■ C]— DISTRICT MO 014 1. MAl M1( FG CONTRACTOR 'D S. �-/d ADDRK" COI!Q cnoN DATA CITY TEL N0. STATION DEFTH STAT[ LIC MANH OL[R[FLII NCI UPPP LICENSE NO, ti-A-98 LOWER NO. DESCRIPTION OF WORK FE[ TYPE OF CONNECTION LENGTH FROM MOUS[SEWER CONNECTING TO Y. CURE P.L M.L TO FA- PUSLIC SEWEI! •■.00 F G.NO ■ FTIC TANK, O[FIT OR CO.IMP.NO. Job NO. FITS AND/OR DRAINFI[LD E10.00 GUS[SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL DISOSAL SYSTEM 51.00 CJ CONNECT ADDITIONALOLD4.OR AFFIDAVIT SAItn VnCWT RECORD.IN■TR.NO. DATE U WORK TO HOUSE■EWER 51.00 OVERFLOW■[[PAGE PIT.DRAIN FIELD c:) El[TN..CL"POOL.DRYWELLMANHOLE 10.00 AL R.REPAIR ABANDON O HWM. OR■T.WIDlfNING SEWER OR IDISPV&ALAYSTRU ].00 STATE ENCROACHMpfT PERMIT NO. C/3� INDU■TR AL MAST[APPROVAL F Y 00 CONNECTION CHARD[F[[ CHAPq AUTHOH=TION I TOTAL FM- I HAVE AT THIS DAT[ A LORTRA(.T WITH THE HEREIN NAMED COMBEE - REIMBURSEMENT F TRACTOR TO,CONN[CT THE AMOVE DESCRI■ED EXISTING DWELLING TO THE PUBLIC APPEOVAIS DATE INIPECTQR'■SIGNATURE SIGNED THIS DAY OF ID� OWNER ORp, NEW HOUSE/[WO[ OWNER■AGENT G CONNECT ADDITIONAL ADDRESS � �. G BUILDING OR WORK SEPTIC TANK.SEET,PIT(8) I H[R[■Y ACKNOWLEDGE THAT HAVE READ THIS APPLICATION ANO/OR DRAINFIELD AND STAT[ THAT THE A&QVE I■ CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE TING REGULATING C[■1POOL ElDRYW[1.L [IPLUMMING AND ■EWERS. IHERESY CERTIFY THAT 11 AM PROPERLY REGISTERED AND/OR ALTER,R[FAIR./EWER OR LIC[NA[D AS REQUIRED ■Y LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNED AND INTEND TO DISCONNECT PLUG AND REST D[ IN, THE AMOVE O RIMED RE/IDKMT�� AMANDON HOUBX SEWER SIGNATURE //�� OF FUt MI'l l `Y JACKF14L/[FEC TANKS ❑ SEEN.PIT(/) CK"POOLS VAI.IDATIO JACK R. ALLEN CK. M.o. USH 8UPERVIBING MECHANICAL ENGINEER tAr- 63TOP- AI.1614 1 0 B 5.00- 9 l C[/Q] -'- `APPLICATION FOR PERMI TSA e�:M,D. — ��•. � COUNTY OF LOS ANGELS SEWER—SEWAGE POSAL DZPARYMENT OF COUNTY ENGIN<<R BUILDING AND SAFZTY DIVISION ■ulLDlnG JOHN A. LAMBIE. COUNTY KNOT Nft[R ADORw1,V j COLEMAN W, JENKINS. SUPT. OF BUILDING LOU L IT/ � N[AR[ST FOR APPLICANT TO FILL IN CROS, ST D[.CRIrTIOTi, LOT NO. OWNER MAIL /LOCK/! y /Xo T T nNeA 93-17 A- p 21 1 OF LOT NOW OM LOT CITY TEL. NO. U/[ OF DI/T111 O. GROUP MAP PROCESSED SY ■UILDIMOL /a BK ro CONTRACTOR 'r V V �d ADO HESS COxxEC?!ox nJlrA STATION DEPTH CITY - TEL. NO. STAT[ LIC MANL HOE REF E MCU LIC[NS[ NO, tLAS1/ R NO. DESCRIPTION OF WORK FEE TYPE 6p,GON On LLN OTHagr HOU■E SEWER CQMNKCTING TO Y. CUR■ PU/LIC SEWR .0 [15.00 SEPTIC TANK 24MPAGIEPIT OR P.0 - FITS AND/OR DRAINFI ELD 41 510.00 Co.IMP.NO. NO. HOUSE SEWER CONNECTING TO TRUNK PK"rT NO. TERM IT NO. PRIVATE DI/PO/AL/Y15T[M 0 33.00 CONN[Cl ADDITIONAL AFFIDAVIT E�fYo RECORD. .NO. DA S WORK TO HO USE ■ ER 0 S.3A0 OVERFLOW SEEPAGE PIT.DRAINFI[LD _CED■POOLDRYW[LL MANHOLE 0 i■.f>D O ALTIIER.R AIR ORAILAND ONWR HWY.OST. DENING SEWER OR DISPOSAL SYSTEM 3.00 STATE[ NT OACHME FERMI O. INDUSTRIAL ��}�� WAST[APPROVAL OYY1�E3 s PERWr $ 21 OO CHARGE/ CONNECTION CHARD[FEI AOTHOEIZATION rorru. FEE I HAVE AT THIS DATE A GORT7tA.G' WITH H[ HEREIN NAMED CON- RIINEUR/EMENT I" TRACTOR TO,CONNECT THE ABOVE D SEED D TO THE PUBLIC • R APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 1G� OWNER OR NEW HOUSE BIWER OWNERS AGENT CONNECT ADDTTI(]♦1A A DORLB �` ■UILDING•UR WORK I SEPTIC TANK Si T(S) 1 HEREBY ACKNOWL�G[ THAT.1 HAVE D THIS A IUTION A-MD/OR DMI NF111 LD AND STAT[ THAT TH[ ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND /TATE E LAWS RGULATING PLUM BIND AND SEWERS. C K"POOL ❑•DRYWELL ❑ I HlRI BY CERTIFY THAT I AM PROPERLY REG19TEPUM AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REGUTAXD BY LOS ANGLE/ COUNTY AND STAT[ OF SEWAGE DISPOSAL BY STEM CALIFORNIA OR THAT 1 AM THE LEGAL O N[R OF, AND INTI ND TO DISCONNECT PLUG AND RESIDE IN, THE ASO D RIB[D PROPERTY. ABANDON HOUSE SIW[R SIGNATURE BACKFILL SEPTIC TANKS ❑ OF P[F( S[EP.PR(S) IJ C[MPOOLJ /uALIDATION JACK R. ALLEN SUPERVISING MECHANICAL ENGINEER CATH q LAC, 6866R SEP2210 D 5.00 0 S&E-689 If•SS APPLICATION FOR PERMIT 1 5&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, SUPT of BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS ST. LEGAL OWNER DESCRIPTION LOT N0. MAIL BLOCK TRACT ADDRESS NO.OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF BUILDINGS DISTRICT NO. GROUP MAP BK PG CONTRACTOR ADDRESS .7 7 CONNECTION DATA STATION DEPTH CITY TEL. N0. MANHOLE REFERENCE UPPER /� STATE LOWER REGISTRATION NO. 6 {� ❑ COUNTY No. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNEC N ENGTH FROM PUBLIC SEWER @ $3.50 Y• CURB P.L. M.L. TO P.L. SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3.00 fOVERFLOW SEEPAGE PIT,Dit*+N+�6LD C. NO. E @ $2.00 (1 CO. IMP. NO. J NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD ERM IT 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 $ i 00 REIMBURSEMENT FEE AUTHORIZATION I TOTAL FEE S 1 I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER SIGNED THIS DAY OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL DRYWELL ElAND 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 I 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 T E LEG L OWNER OF THE ABOVE DESCRIBED RESIDENT L PROP Y. BACKFILL SEPTIC TANKS❑ SIGNATURE `- SEEP.PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE JOHN A. LAMBIE, COUNTY ENGINEER VALIDATIO4,,. ROBERT A. WOOD. CHIEF PLBG. INSPECTOR CK. N.0. �C"Av 4231 ucv13 4 3.00 M