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Home My Public Portal About5008-10 HELEO AVE_Sewer__ .EBOB+l.gy APPLICATION FOR PERMIT TBA6A2D u 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 1..� NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL C �Y/Q�T�' DESCRIPTION LOT NO. EJ OWNER /EYT MAIL BLOCK TRACT 9 ADDRESS NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF BUIL°'NGS L S' D15TRIIT NO. GROUP MAP PROCESSED BY R BK PG CONTRACTOR ��• 0i4v1S, Y` ADDRESS 17.2 fy/ITV T-. CONNECTION DATA TATION DEPTH CITY TEL. NO. El STATE MANHOLE REFERENCE UPPER REGISTRATION NO. ❑ COUNTY LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONN CT LENGTH FROM HOUSE SEWER CONNECTING TO OG Y. P.L. M.L.TO P.L. /J(, PUBLIC SEWER @ $5.00 , SEPTIC TANK,SEEPAGE PIT OR P.C.NO. O PITS AND/OR DRAINFIELD @ 810.0° CO.IMP.NO, JOB NO. / V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. [. VIT •IYtR SEM[ PRIVATE DISPOSAL SYSTEM S3.°° CONNECT ADDITIONAL BLDG,OR AFFIDARECORD, INST..NO. I DAY. W°RHTOHOUSESEWER SSOO OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPO°L.DRYWELL,MANHOLE a 55,00 ALTER,REPAIR OR ABANDON HOUSE I HWY.OR 5T.WIDENING $EWER OR DISPOSAL SYSTEM 53.00 STATE ENCROACHMENT PERMIT PERMIT NO. n INDUSTRIAL WASTE APPROVAL OWNER'S PERMIT E z ooOOF CHARGES _ AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER. DATE INSPE °R'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION SEPTIC TANK,SEL. T(S) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AN°/°R ALTER,REPAIR,SEWER OR LICENSED AS REOUIREO BY LOS ANGLE5 CO TY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWN AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE ABOVE ° CRIBE RESIDEN IA PROPERTY. ABANDON HOUSE SEWER SIGNATU ORE F PERMRTEE BACKFILL SEPTIC TANKS ❑ ❑ SEEP,PIT(Sl ❑ CESSPOOLS VALIDATION ROBERT WOOD cK. M.o. CASH SUPERVISING MECHANICAL ENGINEER ori 0 4 6 0 1`-d 1 P �_ 1 0 D `]+. O zl A GEB.B 3.6B'6A69 fl APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. County Engineer AOOREss /7 L WILLIAM A. JENSEN, Supt of Building j r LOCALITY L NEAREST FOR APPLICANT TO FILL IN `ROSS ST. LEGAL j r DESCRIPTION LOT NO. ✓— OWNER 7R / y M' /33(a MAI` BLOCK TRACT ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF M DISTRICT NO GROUP MAP PROCESSED BY BW L.'NGS `•{ 4 J CONTRACTOR � a ,,��vq��L ADDRESS J 7a O `'y,(F/ / ( r4 /� L, CONNECTION DATA CITY f5Zi¢ D Gtiv14 TEL NO.jp: S t 0�G/�O ATION OI DEPTH O 3/ 2 - ❑ COUNTY MANHOLE REFERENCE REGISTRATION NO. Z LOWER NO, DESCRIPTION OF WORK FEE TYPE OF CONNECT LENGTH FROM �. HOUSE SEWER CONNECTING TO Y. - CU P,L M.L.TO P.L. O PV BLIC SEWER ® $5.00 r- SEPTIC TANK.SEEPAGE PIT OR CO.IMP.. JOB NO. .NOP.C.NO. V PITS ANO/OR GRAINFIELD @ SIOOO HOUSE SEWER CONNECTING TOTRUNK PERMIT NO. ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ f3.00 . /N CONNECT HOUSE SEW BLDG.OR AFFIDAVIT WMVEP •[[�[ RECORD. INSTR.NO. DATE `jrRWJ/ CON C HOUSE SEWER f3.00 [ OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CE55POOL.ORYWELL,MANHOLEB 11.00 • y ALTE R.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING 2 SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT Sn / PERMIT NO. /T l� INDIISTRI AL WASTE APPROVAL OWNER'S PERMIT :I CHAP ES AUTHORIZATION TOTAL FEEI jr - CONNECTION CHARGE FEE I 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 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANO/OR DRAISEPTIC TANK,SEER PITIB) NFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ILL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ ORYWELL ❑ 1 HEREBY CERTIFY THAT 1 AM PROPERLY ISTEREO ANO/OR ALTER,REPAIR.SEWER OR LICENSED AS REG V'REO BY LOS ANGLES CO N Y AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNE O . AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE ABO O CRIBEO ESIGENTA PROPENTY. ABANDON HOUSE SEWER SIGNATURE ` �y - -/n ❑ OF PERMITTEE bG•I/�-/' BACKFILL SEPTIC TANKS SEEP.PITI51 ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.0. CASH ,_1u O 4 b 0 2.4; ;'.;( 13 1 , D 5,,, ,J- GEB°B—,•_sz. APPLICATION FOR PERMIT TBAB42D COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING L+-00 L_ -:-0�, JOHN A. LAMBIE. County Engineer ADDRESS cJ WILLIAM A. JENSEN. SuP t of Building LOCALITY / 4 NEAREST FOR APPLICANT TO FILL IN `ROSS ST. LEGAL DESCRIPTION LOT NO. OWNER ✓ / - r ' MAIL BLOCK TRACT / � �J�'r 9 ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF �J '•� BU ILOINGSDISTfl ICT NO. GROUP MAP PROCES%y3//E/9//'�T �J G 5 BK to CONTRACTOR �. � � �/�j'�(� ADDRESS ��ZJYy�'A,LI/ �,� /J� CONNECTION DATA CITY (T/ P�/(T��("TEL. NO `r� Tb�V STATION DEPTH UPPER REGISTRATION NO. J� QCOO NTY MAN LE F I LOWER 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 SEPTIC TANK.SEEPAGE PIT OR P.C.NO. U PITS AND/OR GRAINFIELD $10.00 CO. IMP. NO. JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. O PRIVATE DISPOSAL SYSTEM $3.00 FF A IT W/.IV[q CONNECT ADDITIONAL BLDG.OR AEA51RINI RECORD, INSTI NO. DATE WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT.GRAINFIELD '4 EXTN..CE531DOL.ORYWEL1.MAN TO LE@ $5.00 ALTER.REPAIR OR ABANDON HOUSE HWY,OR ST.WIDENING SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERCHARGES S PERMIT ' s z oa AUTHORIZATION I TOTAL FEE ON NECTION CHARGE FEE I 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_ OWNEROR NEW HOUSE SEWER OWNERS AGENT_ CONNECTADDITIONAL ADDRESS BUILDING OR WORK LADANDON ANK,SEEP.III(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION GRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND 5 E ERS OL ❑ DRYWELL ❑ HEREBY CERTIFY THAT 1 AM PROPERLY REGISTE 6 ANREPAIR,SEWER OR LKENSEO AS REQUIRED BV LOS ANGLES COVNTY ND STATE OF DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TONECT PLUG AND e RESIDE IN, THE ABOVE ESCR D RE31 TIAL RO PTY, N HOUSE SEWER SIGNATURE ❑ OF PERMITTEE_ L SEPTIC TANKS TIS) ❑ CESSPOOLS ❑ OVALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CASH Low5 4 7�2 ;-W i 0 1o rE 5r-,0., 14