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Home My Public Portal About10132 LA ROSA DR_Sewer__ oma ^L O S A- CE8088-aa APPLICATION FOR PERMIT caaoe COUNTY OF LOS ANGELES - - $9,WWER7, SEWAGE DISPOSAL DEPAATMENT'OF:COUNTY ENGINEER : - . . BUU.DING AND SAFETY'DMAODSION - 'em LDRESSsIxGr t�//)� " )) , aL ' •i . %OF3lI; Ab.LAIM E.?' E asst CABS rr GHIFF'IN,f9aP t o2�uilLinp - „ ' - c ,.fes..=".. LOCALITY . NEAREST, =^ FOR'.APPLICANT TO,F.ML IN CROSS-STr LEGAL DESCRIPTION LOT NO. BLOCK TRACT �. MAIL' ADDRESS NO.OF SIZE OF LOT, NOW ON LOTS. CITY TEL N0. `1 ` USE.OF BUILDINGS ^' DISTRICT x0. GROUP B BK PG MAP ' I PROCESSED BY ' CONTRACTOR ABDREss CyONNECTION.DATA CITY TEL.NOXe/ b iATION -7 ./-•� � DEPTH: STATE MANHOLE REFERENCE L: STA NO, � . - � ❑. .COUNTY:' CC. /� ;.-LOWER. rxo: DESGRIPTION.OF WOR%K FEE - - i HOUSE SEWER CONNECTING TO - PUBLIC-SEWER @ 53.00 7E0 ,CONNECT N LENGTH SEPTIC'TANK,SEEPAGE PIT OR Y. 'C /P:L. M.L.To P.L. PITS.AND/ORDRAINFIELD - @ 53.00 OVERFLOW SEEPAGE PIT,DRAINFIELD - EXTNf.CESSPOOL.DRYWELL @ 52.OD PRIVATE SA SEWERCONNECTING TO L SYSTEM AT@ S1.00 CO.IMP. NO. "JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT -NO: - -ROAD PERMIT N WOR K TO HOUSE SEWER. @51.00 i SLWER ORD SPO AA SYN�EM / // @ SL00 STATE ENCROACHMENT , PERMIT NO. INDUSTRIAL - WASTE':APPROVAL _ - - CHARGES - OWNER'S ' PERMIT. , f CONNECTION CHARGE FEE. - ,AUMORIZATION TOTAL FEE REIMBU RSEMENT.FEE IHAVE AT THIS DATE A CONTRACT WITH THE.HEREIN,NAMED CON- .3 RACTOR ON-TRACTOR TO: CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE JO THE PUBLIC SEWER. SIGNED THIS DAYOF 19_ NEWHOUSESEWER. ..� OWNER OR - CONNECT ADDITIONAL :OWNERS AGENT- - `e- BUILDING':OR WORK ADDRESS 'SEPTICTANK,SEEP.'PIT(S) .AND/OR DRAINFIELD 1 HEREBY-ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION' .AND STATE THAT THE ABOVE IS :CORRECT AND AGREE TO:'COMPLY CESSPOOL Cl DRYWELL ❑ WITHiALL COUNTY .ORDINANCES ANDSTATELAWS REGULATING ALTER,REPAIR,SEWER OR _ PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT i -AM: PROPERLY REGISTERED DISCONNECT PLUG AND ' LICENSED: AS REQUIRED BY LOS ANGELES COUNTY AND STATE°OF ' 'r.DISCONNCT PLUHOUSE G AND CALIFORNIA OR' TH I AM THE' LEGAL OWNER OF THE ABOVE DESCRIBED RESIpE IA {PROPERTY: . BACKFILL SEPTIC TANKS ❑ - - SIGNATURE - .':. - .SEEP.;FIT.(S) ❑',CESSPOOLS. OF.:PERMITTE �'- :. . VALII)ATIO UR BERT A. WOOD — - �, 'M•p• AASH - SPERVISING MECHANICLIN A_ ENGEER LSC 9 4 8 4 "AAR 13 1 1 0 2 5.00'0_ M. Teeeaeo Oseoe a•eo APPL#'CATION FOR PERM.IT- COUM OF LOs ANCEiES SEWER,.,SEWAGE .DISPOSAL DEPARTMENT OF CdUNTY`EN1� 7 It. - SUU.DING AND BUIEDInG ; •ADDRESS �'�- c•, LOCALITY 'TjO FIICRnssSST.EGAL mi'.DES C RI ILOT NO G / ' , i OWNER MAIL BLOCK'' `TRACT jr. f ADDRESSNO.,OPB DGS. SIZEDF LOT NOW ON LOT' CITY TEL NO• USE DI � DISTRICT NO. .GROUP -MAP PROCESSED BY�BUI LDINGS .r BK PGCONTRACTOR ~".ADDRESS - 8' a'`' .CONNECTIONDAZZ CITY ) TEL..NyO.� TION � DEPTHREGISTRATION,NO. /3 0;-/•.� TY MANHOLE REFERENCE -_No. I- DESCRIPTIONOFWORK _FEE ,. ' _ ♦°,.. HOUSE,SEWER CONNECTING TO PUBLIC,SEWER - '@ $$:00 TYPE OF CO EL , LENGTH FROM; SEPTIC YgNK,SEEPAGE OR Y. C P.L. M.L.TO'P.L. .PITS AND/OR GRAINFIELD OVERFLOW.SEEPAGEPIT. DRAINFIELD - - EXTN..CESSPOOL DRYWELL @ $2.00 (. HOUSE SEWER CONNECTING T0. - O P.C.N0. PRIVATE DISPOSAL SYSTEM @SLOG CO.IMP.N0. JOB NO. .:WORK TOT OUSE'S=OR LOO TRUNK PERMIT N0. ROAD PERMIT N0. !'ALTER',REPAIR ORSTATE ENCROACHMENT - - ' 'SEWER-0R DISPOS81.00 PERMIT:No.INDUSTRIALWASTE APPROVACHARGESOWNER'S $ 2: 00 'CONNECTION CHARGE FEE AUTHORIZATION6 REIMBURSEMENT FEE I HAVE AT THIS DATE,A CONTRACT WITH THE HEREIN NAMED.CON. FTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING [ABANDON APPROVALS DATE,, INSPECTOR'S SIGNATURE, . �,TO THE PUBLIC SEWER.. = _ ;. f SIGNED THIS DAY OF ' 19_ NEW xousE seweR � fw. �If� .; OWNER OR ECT'ADOITIONAL - 'OWNERS AGENT DING'OR WORN I IC TANK,SEEP.PITS) ADDRESS OR DRAINFIELD. ,. I .STATE: ACKNOWLEDGE ABOVE IS I HAVE' READ THISAPPLICATION - - - -;AND STATE CTHAT OUNTY ORDINANCES IS CORRECT AND AGREE TOCOMPLYPOOL ❑ ORYWEIO �- - :WITH'ALL COUNTY ORDINANCES :AND STATE`LAWS REGULATINGALTER,REPAIR,GEDISPOSALSEWER SYSTEPLUMBING AND SEWERS _ - A GEDISPOSAL SYSTEM -LEHEREBY CERTIFY'THAT I S4A GELE COUNT(SAND, AND/ORONNECT PLUG.AND LICENSEDAS REQUIRED BY LOSANGELES.BOUNTY F THE AABOVOF EDON.HOUSE SEWER CALIFORNIA OR. ETHATNTI 1 AM THY.'- GAL OWNER OF THE':ABOVEDESCRIBED RESIDENiI PROPERTY KFILLSEPTIC TAN L:•PITIS CE OLS >..OF PERMITTEE ®r o - I �VAIdDATIOROBERT A. W OD Wtl SUP , - EA", NG MECHANICAL ENGIN .- w �A94'83 . NAR 13 :1_ G p 5 .00 , .: _ TEMPLE CITY CE808o COUNTY OF LOS ANGELES TION FOR PERMIT - cseoe e.aP 7 .DEPARTMENT OF COUNTY ENGINEER SEWER SEWAGE DISPOSAL PPLIC BUILDING AND SAFETY DMSION BUILDInG sv1 ADDRESS lJ�x . JOHN Al LAMBIE CouutT Egn� eer CASSATT:;D GAIFFIN SSuP�tyel'B4556 ,LOCALITY / - .. . } :.NEAREST '•.: FOR`APPL'IC,ANT'�TOFILL'1N'' CRO 55 sr. LEGAL DESCRIPTIONOWNER � LOT NO. /yY- IC �/ BLOCK ` TRACT ! ��' - MA .:' S ADDRU IL v J 's� NO.OF.BLDGS. SIZE OF LOT /� NOW ON LOT ITYd: - .TEL N0: ,USE OF - BUILDINGS (DISTRICT N0.I GROUP :S.gMAP - I E$OCES 'BT CONTRACTOR OC - ,', ^ Li BK PG L{J r♦ L/ ADDRES ,.,T�'I r CONNECTION DATA - CITY �W P Q- TEL.N0//,N��/-6 } �(� '-STATION DEPTH UPPER 9 - REGISTRATION NO. .4 Tg 7 / COUNTY MANHOLE REFERENCE - LOWER- NO. DESCRIPTION OF WORK FEE. - HOUSE SEWERCONNECTING TO PUBLIC SEWER-' @ S3.00 ` - TYPE OF NECTION. .LENGTH. OM SEPTIC TANK.SEEPAGE PIT OR Y. RB P.L.- M.L.-TO .PITS AND/OR GRAINFIELD @ S3.00 OVERFLOSSW S EEPAG E PIT,DRAINFIELD EXT . :CEPOOL. DRYI LL @ $2.00 HOUSE WECONNECTING TO - - P.C.N PRIVATE+DI SPOSAL SYSTEM . @S1.00 Co - JOB NO. CONNECT:ADDITIONAL BLDG.OR TRUNKPERMITNO. ROAD PERMIT NO. - WORK TO HOUSE.SEWER @ SI.00 i EWE��A9YST EM HOUSE @ $100 - (� ..STATEENCROACHMENT - - s :PERMIT NO. w.. '`:INDUSTRIAL' G t WASTE APPROVAL - ...CHARGES. OWNER'S PERMIT $ 2. 00 CONNECTIOH CHARGE:FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT. MED CON. TRACTOR TO CONNECT'THE ABOVE DESCRIBED EXISTING S DATE A CONTRACT WITH THE HEREIN ADWELLIING.� _APPROVALS DATE INSPECTOR'S SIGNATURE TO THE'PUBLIC SEWER. SIGNED:THIS _DAY O tY9� NEW.Ho SEWER OWNER OR `CONNECT ADDITIONAL OWNERS AG EN��ti/A w� `i /! �1.//r�—x"��- "BUILDING OR WORK ADDRESS�72-� ll d-sh•t '��s•+ 1.J. :' SEPTIC TANK.SEEP.PIT(S) .. .„.._. .:AND/OR DRAINFIELD F.. 1 HEREBY ACKNOWLEDGETHAT1 HAVE' READ'THIS -APPLICATION ! SAND STATE THAT�THE ABOVE IS:CORRECT AND AGREE TO COMPLY nCESSPOOL ❑ DRYWELL ❑ WITH P ALL COUNTY -ORDINANCES AND STATE LAWS.,,REGULATING +:':ALTER:REPAIR.SEWER OR - PLUMBING AND SEWERS. SEWAGE DISPOSALSYSTEM t 1 ' 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR :DI SCONNECT PLUGAND "LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND 'STATE OF 'ABANDON NOUSE SEWER CALIFORNIA OR THAT I AM`THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY .BA CKFI L L SEPTIC TANKS ❑ SIGNATURE -:SEEP. PIT(S) ❑ CESSPOOLS - 'OF'-PERMITTER - - - ®' VALIDATION ROBERT A, WOOD CS li.e: CASH ,SUPERVISING MECHANICAL ENGINEER, - \l 5 4'9'3 'OV 2.'j .1 0D 3.0 0