The URL can be used to link to this page

Home My Public Portal About6153 KAUFFMAN AVE_Sewer__ r . CEAAPPLICATION FOR, PERMIT 64 76A642D' �f COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING m JOHN A. LAMBIE, County Engineer ADDRESS �/� WILLIAM A. JENSEN, Sup't of Building LOCALITY �� I 'NEAREST ,w ,I FOR APPLICANT TO FILL IN GROSS ST A LEGAL DESCRIPTION LOT NO OWNER I„ MAIL C BLOCK TRACT ADDRESS NO OF BLOGS Q 6 3 SIZE OF LOT NOW Ir ON LOT CITY / C TEL. NO. USE OF DISTRICT NO GROUP MAP PROCES BY, BUILDINGS �t A• '' ,p "_/� -1 BK PG _ zcQ: CONTRACTOR p 5 C /*/ `, LJU(� ./ ADDRESS 4 s 5 J le CONNECTION DATA CITY W J AJ, EL 33 75_4JT77 STATION DEPTH El STATE UPPER REGISTRATION NO ❑ COUNTY MANHOL REFERENCE LOWER ° NO DESCRIPTION OF WORK FEE ' TYPE O CONNECTION LEN ROM HOUSE SEWER CONNECTING TO Y. URB P.L. OPLL. PUBLIC SEWER @ 35 00 P. G.NO. �- SEPTIC TANK,SEEPAGE PIT OR CO.IMP. NO JOB NO. d PITS AND/OR GRAINFIELD @ 310.00 O HOUSE SEWER CONNECTING TO TRUNK PERMIT ROAD PERMIT NO. (� PRIVATE DISPOSAL SYSTEM @ 53.00 CONNECT ADDITIONAL BLDG OR AFFID w�lv[[ [4S[M[RT RECORD R.NO. DATE O WORK TO HOUSE SEWER 0 $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD H EXTN,CESSPOOL,DRYWELL,MA NH OLE @ 35.00 V N HOUSE HWY.OR ST.WIDENING LU ABANDO /fI RC1 a DISPOSAL BYSTEM @ $3.00 G'—IJ STATE ENCROACHMENT Z PERMIT NO. _ o INDUSTRIAL - WASTE APPROVAL CHARGES OWNERS PERMIT S 2 00 AUTHORIZATION TOTAL FEE L 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 BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP,PIT(S) IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD - AND STATE THAT THE-ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING.AND SEWERS - CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL S YSTEM � yp CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE _ DES IBED RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER l SIGNATURE BACKFILL SEPTIC TANKS ❑ �/ �S f I w OF PERMITTEE SEEP.PIT(S) ❑ CESSPOOLS VALIDATI RO ERT A. WOOD CK: M O' CASH SUPERVISING MECHANICAL ENGINEER ' i-AC0- 0 D 6 1 W SEP .1 U p 5.00- 1 TEMPLE CITY DEB06 5.65 APPLICATION FOR PERMIT 76A 642D COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMRIE, County Engineer ADDRESS 61153 N. Kauffman Aim . COLEMAN W. JENKINS,Sup't of Building mTy'� nn LOCALiTV Temple City ltyy NEAREST FOR APPLICAN_T TO FILL IN CROSS BT - r.-i n l i Aup 'E GAL DESCRIPTION LOT NO OWNER MAIL BLOCK TRACT ADDRESS9541 'f'tj 1 NO OF BL GS SIZE OF LOT NOW ON LOT CITY emnle 1 TEL NO USE OF DISTRICT NO GRr MAP PROCESSED BY BUILDINGS / L) BK PG�j.� CONTRACTOR Square1 "}n r,,r-t �.JICL•l� ' ADDRESS 2953 Maas Oil Rd• aCONNECTION DATA CITY R.1 M o nt e. TEL NO /> T ION LICENSE LICENSE ,Y NO 128870 CLASS MANHOLE REFERENCE (, LOWER NO DESCRIPTION OF WORK FEE T E OF NNE �--'� LENGTH ROM -� 1 HOUSE SEWER CONNECTING TO Y C P M L TO 0 L PUBLIC SEWER @ $ 5 00 p C.NO SEPTIC TAW, SEEPAGE PIT OR JOB NO d PITS AND/OR DRA INFIELD C $10 00 CO IMP. NO. / O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO. /_ U PRIVATE DISPOSAL SYSTEM @ $ 3 00 IIICCCJJI CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVER EASEMENT RECORD INSTR NO 13ATE WORK TO HOUSE SEWER @ $ 3 00 O ' REPAIR'A LrrFT ABANDON HOUSE r SEWER OR DISPOSAL SYSTEM @ $ 3 00 ILIW HWY ORST WIDENING d. EXTN.,CESS POO L, MANHOLE @ $ 5 00 STATE ENCROACHMENT ' PERCOLATION TEST @ $ 5 00 PERMIT NO z INDUSTRIAL WASTE APPROVAL OWNERS PERMIT 2 00 CHARGES CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE I HAVEAT 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 BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL Cl DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER, REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY ND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL ROPE TY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP,PIT(S) ❑ CESSPOOLS ❑ OVALIDATION CK M 0 CASH T124PLE CITY 764 52D 6A .65 • APPLICATION FOR PERMIT 76A 64 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDINGN- Kauffman Ave, USS JOHN A.LAMBIE, County Engineer ADDRESS J� COLEMAN W. JENKINS, Sup't of Building LOCALITY T- ne it V NEAREST FOR APPLICANT TO FILL IN `ROSS ST. ; '; Av LEGAL DESCRIPTION LOT NO eZ OWNER t MAIL BLOCK TRACT ADDRESS 1 E. Olema St. NO OF BLDGS SIZE OF LOT NOW ON LOT CITY Tem le jt _TEL NO. USE OF BUILDINGS K DISTRICT NO GROUP MAP P PROCESSED BY (.>`'t Ef�l /� CONTRACTOR p�-r. ✓, �J � V ADDRESS2933 Maxsnn Rd - CONNECTION DATA CITY 1 - lonte TEL NO 444-2020-2020 ION , DEPTH LICENSE LICENSE / NO CLASS -1 MANHOLE REFERENCE l LOWER NO DESCRITION OF WORK FEE TYPE OF CONNECTION LENGTFROM _/ HOUSE SEWER CONNECTING TO Y CURB P.L. M L T L PUBLIC SEWER @ $ 5 00 PTI TANKEPIT OR ^� P.0 NO . EPAGE t PITS AND/OR DRAINFIELD @ $10 00 CO IMP NO /`,� JOB NO /L O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO (, U PRIVATE DISPOSAL SYSTEM C $ 3 00 CONNECT ADDITIONAL BLDG ORAFFIDAVIT I WAIVER I EASEMENT RECORD. INSTR NO 15ATF WORK TO HOUSE SEWER @ $ 3 00 O R ABANDON HOUSE SEWER OR DISPOSAL SYSTEM C $ 3.00 HWY OR ST WIDENING n / EXTN.,CESS POO L, MAN 11OLE @ $ 5 00 N STATE ENCROACHMFy T y PERCOLATION TEST @ $ 5 00 PERMIT NO f� 6 INDUSTRIALI Saddle 2 00 WASTE APPRO\4 / CHARGES OWNERS PERMIT S Y Cb(5C AUTHORIZATION TOTAL FEE 2500CONNECTION CHARGE FEE 1 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 BUILDING OR WORK ADDRESS SEPTIC TANK SEEP,PIT(S) , I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING C PLUMBING AND SEWERS I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPA SEWER OR ILCALIORN AS REQUIRED BY LOS ANGLES CO NTY AND STATE OF SEWAGE DISPOSAL SYSTEM A OR THAT I AM THE LEGAL OWN OF, AND INTEND TO DISCONNECT PLUG AND THE ABOVE DESCRIBED RESIDE IAL ROPERTY. ABANDON HOUSE SEWER BACKFILL SEPTIC TANKS ❑ITTEE SEEP.PITS) ❑ CESSPOOLS ❑ ALIDATION CK M.0 CASH 1 4 9 9NOV 1 1 1 D 25.00- ,_A