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Home My Public Portal About9555 KENNERLY ST_Sewer__ SINE-6eO I - APPLICATION FOR PERMIT 1 .eD IVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Depa=tment of County Engineer County of Los Angeles BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT D GRIFFIN, SUP T OF BUILDING LOCALITY FOR 'APPLICANT TO FILL IN CROSS s - 1 LEGAL DESCRIPTION LOT NOOWNERC MAIL BLOCK TRACT ADDRESS / d NO OF BLDGS � SIZE OF LOT NOW ON LOT CITY. - TEL NO USE OF DISTRICT NO GROUP I MAP PG BUILDINGS BK CONTRACTOR ADDRESS CONNECTION DATA STATION DEPTH CITY TEL MANHOLE REFERENCE UPPER ❑ STATE LOWER REGISTRATION NO ❑ COUNTY 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 @ $3 50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD Q $3 00 OVERFLOW SEEPAGE PIT,DRAINFIELD P C NO. EXTN ,CESSPOOL,DRYWELL,MANHOLE Q $2 00 CO IMP NO 10B NO R/Hr HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO ROAD PERMIT 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 OWNER'S PERMIT 1 00 AUTHORIZATION I TOTAL FEE I I REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR SSIGNATURE 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 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AN LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE D OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP- PIT(S) ❑ CESSPOOLS[I , OF PERMITTEE JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CASH ` X1 ,,6 7.9.►-� OCT 24 3 6 10 0,.D'4 &E-6D 5& 89 11•SS APPLICATION. FOR PERMIT 1 8 E-8 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment 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 NO 7' MAIL BLOCK - TRACT. / � Q ADDRESS NO OF BLDGS CITY TEL NO SIZE OF LOT NOW ON LOT USE OF - DISTRICT NO GROUP MAP BUILDINGS ^� BK PG CONTRACTOR CONNECTION DATA ADDRESS CITY TEL NO STATION DEPTH � fi� MANHOLE REFERENCE UPPER REGISTRATION NO El COUT TY LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH AOM HOUSE SEWER CONNECTING TO Y CURB P L M L TO P L PUBLIC SEWER @ $3 50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3 00 OVERFLOW SEEPAGE PIT, DRAINFIELD P C NO EXTN ,CESSPOOL,DRYWELL,MAN HOLE @ $2 00 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO CONNECT ADDITIONAL BLDG OR d 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 $ 1 00 AUTHORIZATION TOTAL FEE 12 a v REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER ,i NEW HOUSE SEWER _ SIGNED THIS AY OF 19 CONNECT ADDITIONAL_ OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS OPLICATION CESSPOOL❑ DRYWELL❑ AND 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 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS S COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT TH EGAL OWNER OF THE ABOVE DESCRIBED RESIDENTI BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE - JOHN A LAMBIE, COUNTiENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CK tl 0 CASH �.AC06 6 1- 5- mAY28 4 2.00 �' 7F-6 &EB6 APPLICATION FOR PERMIT 1 S& DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Deportment of County Engineer _ County of Los Angeles BUILDING JOHN A LAMBIE COUNTY ENGINEER ADDRESS J ,"C�L/� ,G�� / ® _ CASSATT D GRIFFIN, SUP T of BUILDING LOCALITY ;�ys� -,�, e L L-c _ FOR APPLICANT TO FILL IN CROSS ST j LEGAL DESCRIPTION LOT NO I.�� OWNERe/-- MAIL BLOCK TRACT ADDRESS 1 l.P �' NO OF BL CITY TEL NO SIZE OF LOT NOW ON LOTT USE OF DISTRICT NO GROUP MAP BUILDINGS BK �kPG CONTRACTOR X � ADDRESS CONNECTION DATA � STATION —DEPTH J CITY TEL NO MANH LES FF�2ENCE UPPER / Z_STATE OW REGISTRATION NO COUNTY No DESCRIPTION OF WORK FEE OUSE SEWER CONNECTING TOTYPE OF CONNECTION LENGTH FROM �A Y- CURB PL M L TOPL �( PUBLIC SEWER @ $3 50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3 00 OVERFLOW SEEPAGE PIT,DRAINFIELD P C NO / EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $ 2 00 CO IMP NO moi$$-!}S. O {0 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO -J U CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER , 0 $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 $ 1 00 AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN N MED CON- APPROVALS DATE INSP CTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER - NEW HOUSE SEWER SIGNED THIS -yam DAY OF = -��/ 19—G CONNECT ADDITIONAL _ OWNER ORA ) BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP,PITS) ADDRESS - r- AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE AD THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT ABANDON HOUSE SEWER PLUG AND CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) ❑ CESSPOOLS o OF PERMITTEE JOHN A LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CK EI 0 CASH 7 1 9 1- APR ? 4 4 .5 0 LD i