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HomeMy Public PortalAbout9038 HERMOSA DR_Sewer__ DEPARTEffiYT OF COUNTY ENGINEM - -SEWER—SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES Q r WILLIAM J. BUILDING FOX, COUNTY ENGINEER I /��OG fir— ADDRESS crv,.oca. FOR APPLICANT TO FILL IN LOCALITY Tern b EAREST GP [ 1 1 ADDRESS / O E. H E R d S A Dq CROSS Sr. LOCALITY TE M PL F- C 17-Y DISTRICT NO. SERIAL NO. PERMIT NO. ceosssT. S t� LTANp RE-C A/ r/, 1,n 97�Iss S OWNER C ES ARE GOR Y �hnii�ii 6 -3-53 ADDRESS USEZONE OCCUPANCY MAP BK PG CITY %EM PLB G)'rY TEL-NO. fl17 CONTRACTOR R, S , T 4HlGH CO.IMP.NO. � '�,(7Cy ¢ /¢•- ADDRESS 9 JOB.NO. f CITY 7'EM PLE G ITY TEL.NO. A,/• �. $�,((( TRUNK PERMIT NO. STATE REGISTRATION NO. ® COUNTY ROAD PERMIT NO.LEGAL -DESCRIPTION LOT NO. I I ' STATE ENCROACHMENT PERMIT NO. BLOCK TRACT .S CEOs INDUSTRIAL WASTE APPROVAL" 7 SIZE OF LOT N0.OF BLOBS' S NOW ON LOT CHARGES USE OF BUILDINGS CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ = 3.50 cSZ RECEIPTN0. I DATE I'BY "OUSE SEWER CONNECTING TO �� PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER - 1.00 _ ALTER OR REPAIR EXISTING NO. DATE BY' SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER _ AND/DR DISPOSAL SYSTEM 1.00 - CONNECTION DATA SEPTIC TANK.S EEPAGE PITOR PITS AND/OR GRAINFIELD 2.00 STATION � �-• '7_Q DEPTH 7^. CESSPOOL-GRYWELL << SPECIAL CONDITIONS ONLY 2.00 �' C NHOLE REFERENCE tJ UPPER LOWER TYPE OF JON CONNEC LENGTH FROM Y_ CURB J P.L. M.L.TO P.L. �S OWNERS PERMIT $ I I 00 AUTHORIZATION I TOTAL FEE 1� 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER - SIGNED THIS...--S,Z_'.-DAY OF......... Vi e^:+___...19.X.3 NEW HOUSE SEWER •? G-�(j 3 OWNER OR S/ � y ! CONNECT ADDITIONALOWNERS AGEQNT/.�.. Af-�...... ..�_. ?,__, � -,_ .BUILDING OR WORK!.Y.-. _S._._5._._-. ASEPTIC TANK,SEEP.PITS)ADDRESS..-. Y d S. a:__. - .__. . __ .__ SAND/OR GRAINFIELD I HEREBY ACKNOWLEDGE THAT L HAVE READ THIS APPLI-. ;CESSPOOL Q DRYWELL� -. - CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS ,ALTER. REPAIR.SEWER OR _ REGULATINGPLU MBING-AND SEWERS. - -" SEWAGE DISPOSAL SYSTEM - I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT HOUSE SEWER AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OW14- DPLUG AND ER OF THE ABOVE DESCRIBED RESIDE PROPERTY./// BACKFILL SEPTIC TANKS / �, r� SIGNATURE p/ SEEP PIT(S)M CESSPOOLS ( " „ ��•' OF PERMITTEE...- 76A642D 663 1/53 r DEFA2trblENT OF COUNTY ENGWEER� SEWER—SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX. COUNTY ENGINEER - BUILDING ADDRESS FOR APPLICANT TO FILL IN ` LOCALITY BUILDINGG/?JObr //lam NEAREST ROSS T. LOCALITY v DISTRICT NO. SERIAL NO. PERMIT NO. ' 197 /7 S NEAREST A ^ /1a S CROSS ST. • /�^ RECEIVED BY Ready for Ineoaetlon DATE 18/`B..��UED OWNER Cn�O YByo rV �JL'/'/f'btlii/ tw �4'W.3 MAIL ��[[ USEZONE' OCCUPANCY MAP ADDRESS Qp ,� {� }= /y Gl�✓N'O�O©).—• � BK PG CITY r�J'h/1�Lt'a TEL.NO,.,/4T 7— ZO 96 CONTRACTOR -��Tornii�h CO.IMP.N0. /r ADDRESS 2 Q JOB N0. CIT r5T, ELAO. .TRUNK PERMIT NO. STATE RECISTRATIO N0. 8 COUNTY ROAD PERMIT NO. LEGAL STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK TRACT �JO�('' 'INDUSTRIAL WASTE APPROVAL SIZE OF LOT .(a NOW ON LOTS Y 1 � CHARGES/ USE OF \ / BUILDINGS 'CONNECTION CHARGE FEE NO. DESCRIPTION OF WORK FEE \ / HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE / PUBLIC SEWER 0 $ 3.50 RECEIPT NO. 'I\ /DATE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED W ORK TO HOUSE SEWER 1.00 UZJ ALTER OR REPAIR EXISTING NO. I / •DATE I BY SEWER ORDISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 ' CONNECTION^DATA SEPTIC TANK.SEEPAGE PIT OR PITSAND/ON DRAINFIELO 2.00 STATION / DEPTH CESSPOOL—ORYWELL --- SPECIAL CONDITIONS ONLY 2.00 /h7A NHOLE REFERENCE\ UPPER LOWER Y. TYPE OF CONNECTIONLENGTH P.L. M.L.TO p,LROM OWNERS PERMIT $ I 001 AUTHORIZATION TOTAL FEE 1 c a I HAVE THIS DATE CONTRACTED WITH TXE HEREIN NAMED \ CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE' DWELLING TO THE PUBLIC SEWER SIGNED THIS------------------DAY OF...... 19— 1NEW HOUSE SEWER OWNER ORCONNECT ADDITIONAL OWNERS AGENT--------_._......_......................_.........._...................... BUILDINGORWORK ADDRESS---__----------------_------_. .. SEPTIC TANK.SEEP.PIT(S) ......_... ...._........._..._._..........__...._. AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE HEAD THIS APPLI- 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 t AM PROPERLY REGISTERED 'DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES CGUNT ABANDON HOUSE S EWER AND STATE OF CALIFORNIA OR THAT E LEGAL OW ER OF THE ABOVE D IDES ENTIAL PROPEp. BACKFILL SEPTIC TANKS SIGNATURE SEEP.PIT(S)0 CESSPOOLS OF PERMITTEE... ...._......_.._..... .... ...._.. .._ .. .. .. _ _. 76A642D 663 1/53