The URL can be used to link to this page

Home My Public Portal About9144 HERMOSA DR_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETYPERMIT APPLICATION COUNTY OF LOS ANGELES p WILLIAM J. FOX, COUNTY ENGINEER I ADDRESS ' x��e/�� FOR APPLICANT O FILL IN LOCALITY BUILDING NEAREST AGGRESS / CROSS ST. LOCALITY/-,7&- DISTRICT NO. SERIAL NO. ^JsPERMIT NO.. �• NEAREST / +J d I A 2 7ZS CROS$ST. ' RECEIVED BY Ready for Inspection DATEIISSSUED� OWNER MAIL 'ADDRESS `J�f91.� USE ZONE OCCUPANCY SK MAO PG L c r CITY /% TELAO - � I ��v Q_/ CONTRACTOR CO.IMP.NO. /2O / /� 4 `7,-6- ADDRESSe4or / JOB.NO. CITY TEL.MO. X TRUNK PERMIT N0. STAT REGISTRATION NO. COUNE TY ROAD PERMIT NO. LEGAL STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK TRACT,��_ INDUSTRIAL r WASTE APPROVAL S"O X 7 NO.OF SLOGS SIZE OF LOT I� . NOW ON LOT / CHARGES USE OF BUILDINGS /�//�jy/(//� CONNECTION CHARG EE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLICSEWER 0S 3.50 1 J6 RECEIPT NO. X DATE IBy HOUSE SEWER CONNECTING TO ! PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTIO ECORDED WORK TO HOUSE SEWER 1.00 N0. I DATE IBV ALTER OR REPAIR EXISTING 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 GRAINFIELD 2.00 STATION / 'f'w DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 � . MANHOLE REFERENCE <IMRER' LOWER TYPE-OF CONNECTION-- LENGTH FROM /e :YT %XA A6 C_P.L.J M.L.TO P.L. OWNERPERMIT S I DD x// AUTHORIZATION TOTAL FEE �� T'° I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THH BLIC SEWER— SIGNED THIS._L ._._ AY O ... - NEW HOUSE SEWER 5�O OWNER OR CONNECT ADDITIONAL OWNERS AGER :L. ... _ _ . _ BUILDING OR WORK ^, SEPTIC TANK,SEEP.PIT(S) ADDRESS........... Lfl.!-.._... .. lr!/J.Ld ......_... AND/ORDRAINFIELD I HEREBY AC4NOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL DRYWELL� CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL.000NTY 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 AND STATE OF CALIFORNIA OR THAT 1 AM T E LEGAL OWN, ABANDON HOUSE SEWER N,,/_ /AlR OF THE ABOVE CRIBED ENTI PROPERTY. BACKFILL SEPTIC TANKS E] �.i 'YNA.C(�� / e SIGNATURE //// / SEEP.PIT(S)E] CESSPOOLS OF PERMITTEE. _._ ..(,(J..'. . �/r.'�..C........_. moomm 7GA042A 663 7/53 EA0A=° Ceeoe a-ee APPLICATION FOR PERMIT COUNTY of LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING / ADORES$ JOHN A. LAMIE, , Suprturf, E ser CAASATL D. GRIFFIN, Supt of Building LOCALITY � /I Y111—y 11 NEAREST FOR APPLICANT TO FILL IN Cft055 ST. � LEGAL f p DESCRIPTION LOT N0. OWNER %� BLOCK TRACT MAIL ADDRESS 0.OF B Gl�D S. SIZE OF LOT NOW ON LOT CIT TEL. NO USE OF BUILDINGS DISTRI 0. BK GRO MAP PG PROCESSED BY _ CONT2RCTOR / /� ADDRESS CONNECTION DATA L CITY TEL.N0. �, STATION DEPTH ATE MANHOLE R ER NCE UPPER REGIST ION NO COUNTY LOWER NQ. DESCR 0 OF WO FEE HOUSE SEWER CONNECTING TO f.'[.,L � / PUBLIC SEWER @ $$.00 TYPE OF CONNECTION E GTH ROM SEPTIC TANK.SEEPAGE PIT OR Y. CURB P.L. M.L.TO P.L. PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EKTN..CESSPOOL. DRYWELL @ $2.00 HOUSE SEWER CONNECTING TO P.C.NO. PRIVATE DISPOSAL SYSTEM @S1.00 CO.IMP. NO. JOB NO. WORCONNECT K TO HOUSE ADDIT(SEWEBLDG.OR @ SI 00 TRUNK PERMIT N0. ROAD PERMIT N0. ALTER.RFPAiP-BR-kSrtR00N HOUSE STATE ENCROACH NT SEWER ^^^� ^�=__SM @ $1.00 PERMIT N0, INDUSTRIAL WASTE APPR 4, L CHARGES OWNERS PERMIT $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE 6-& REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. TRACTOR TO CONNECT THE ABOVE SCRIB EXISTING DWELLS APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC EW .10 SIGNED THIS DAY OF 19(c_v NEW HOUSE SEWER OWNER OR 7zaWltCONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS 2 4P SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM 4-�f AZTi L � I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON CT PLUG AND CALIFORNIA OR THATfl A THE LEG OWNER OF THE ABOVEHOUSE DESCRIBED RESIDEN L ERTY. BACKFILL SEPTIC TANKS ❑ SIGNATURE SEEP. PIT(S) ❑ CESSPOOLS ❑ OF PERMITTE ®" VALIDATI ROBERT A. WOOD CK. M.o. GSH SUPERVISING MECHANICAL ENGINEER CO 5 3 1 3 2 JAN 18 1 0 A 3.0 0 � .