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Home My Public Portal About9814 LA ROSA DR_Sewer__ E.66311.55 SaE6eAPPLICATION FOR PERMIT 1 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Deportment of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADOR BE ® CASSATT D. GRIFFIN, SUPT of BUILDING LOCALITY FOR APPLICANT TO FILL IN ENEAREST. LEGALDESCRIPTION LOT NO I / ZW60r Fjdq pT�� MAIL r BLOCK TRACT �i J�/� ADDRESS NO. OF BLO __X) CITY TEL. NO. SIZE OF LOT NOW ON LOT � USE OF p / LO DISTRICT NO. GROUP MAP BUILDINGS 12 �b[�.�� SK. PG /_ CONTRACTOR � ,� E A/ CONNECTION DATA' ADDRESS STATION DEPTH CITY TEL. NO. MANHOLE REFERENCE _ _ UPPER ❑ STATE LOWER REGISTRATION NO. ❑ COUNTY ;NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM PUBLIC SEWER @ $3.50 Y. CURB P.L. M.L. TO P.L. 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. JOB NO. HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT N0. / CONN ECT 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 CONNECTION CHARGE FEE OWNERS PERMIT g 00 o REIMBURSEMENT FEE > AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS ' DATE INSPECTORS SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW HOUSE SEWER SIGNED THIS AY OF 19 CONNECT ADDITIONAL 22 OWNER OR BUILDING OR WORK -JO-�� I��J------ _ OWNERS AGENT SEPTIC TANK.SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL❑ ORYWELL❑ 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 1 HEREBY CERTIFY THA I AM PROP Y REGISTERED ANO/OR DISCONNECT PLUG AND LICENSED AS REOUIRED LOS ANG ES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT pM THE L AL OWNER OF THE ABOVE DESCRIBED RESIDENT] ROPERTY. BACKFILLSEPTIC TANKS❑ SIGNATURE SEEP.PIT(S) ❑ CESSPOOLS❑ OF PERMITT JOHN A. LAMBIE, CO TV ENGINEER ,f-'yALIDATION ROBERT A. WOOD. CHIEF PLBG. INSPECTOR rX./ N O. CASH L�ICOo'9 5'3 -AIQ..1,0 1 0 A . 3:=.0a0 13. X -FSM L cy 1-r-,, CEBOB 1 .62 APPLICATION FOR PERMIT T6A BazD COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING 7'nze JOHN A. LAMBIE, County Engineer ADDREss WILLIAM A. JENSEN. Supt of Building �LOCALITYNEAREST FOR APPLICANT TO FILL IN `ROSS ST. EGAL i7i DESPTIO LOT NO. OWNER MAIL AA 61 BLOCK / TRACT ADDRESS SE OF _ NO. OF BLDGS. (� CITY TE, NO. USE OFBUIf f r y DISTRICT NO. GROUP MAP PROC $SED BY LEE rvcs vT•'� II r BK P CONTRACTOR 1.j�l.�y� J 17q �. ADDRESS /'� ��}r..,�— CONNECTION DATA CITY A J} TEL. NOA1 CP " Vb/ STATION. . —er DEPT" j 7Q REG ISTRgTIONRI J % ❑ COUNTSTATE Y MANHOLE flEFEgENCE .0 /. GT O rvo. DESCRIPTION OF WORK FEE `j [p4�gN TION LENGTH R.L.HOUSE SEWER CONNECTING TO I �. ` C Y.} �1/ QCl P.L. M.L.TO .LV PUBLIC SEWER @ E5.00 V �3CS P,C,NO. SEPTIC TANK,SEEPAGE PIT OR G`/ 0 PITS ANO/OR DRAINFIELD @ 410.00 CO.IMP. NO. JOB NO: O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT N PRIVATE DISPOSAL SYSTEM 43.00 YYYJJJ CON N ECT ADDITIONAL BLDG.OR AFFIDAVIT p1Y pSCXEXi RECORD.INSTR.NO. OAT N WORK TO HOUSE SEWER Lm 63.00 OVERFLOW SEEPAGE PIT.DRAINFIBI_ EXTN.,CESSPOOL,DRYWELL.MANHOLEO 55.00 C ALTER.REPAIR OR ABANDON HOUSE HWY.Oft ST.WIDENING SEWER OR DISPOSAL SYSTEM 63.00 STATE ENC ROgCNMEN PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT s z 00 AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TOCTO THERPTO U BLICCONNECTER THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS 72 GATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR �//�7 ny % NEW HOUSE SEWER OWNERS AGENT e /l %A� � CONNECT AOOITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND 5EWERS,* CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR ALTER.REPAIR,SEWER OR LICENSED AS REOUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE A VE DESCRIBED RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE / `R BACKFILL S ❑ OF PERMITTEE SEPTIC TANKS SEEP,PITT S) ❑ CESSPOOLS ❑ VALIDATIOPJ�-1 ROBERT A. WOOD /�/J SUPERVISING MECHANICAL ENGINEER CAS ,9 0 5 '9Q AUG 19 1 0 D e7.00- e x . 110 fv )Z 60` -ITM PiIE C- rTy `ES08 °2 A D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer AD pRE ss A WILLIAM A. JENSEN, Supt of Building , LOCALITY NEAREST FOR APPLICANT TO FILL IN CRUSE 5T. 1r Ir. DESCRIPTIO LOT NO, OWNER MAIL r NO BLOCK TR(ACT /WJE / ADpflE55 V V a NOW ON LOTS CITY SIZE OF LOT b ! TEL. NO. USE OF �j DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS X- BK PG CONTRACTOR i ADOREss rt° „<— / c' CONNECTION DATA CITY jTEL. NO,d [Q/f�AP j•2 STATION 540 Ll T.TC /�DEPTHMJ �7 J �/ g ❑ COUNTY MANHOLE REFERENCE r y,r a� PPE REGISTRATION NO, jCOYE4F NO. DESCRIPTION OF WORK FEE N .TION LENGTH FR ' 1 HOU5E SEWER CONNECTING TO Y. A P.L. M.L,TO P.L. 247 O PUBLIC SEWER @ $5.00 . SEPTIC TANK, .SEEPAGE PIT OR COIMP. NOJOB NO, PITS AN./OR DRAINFIELD � E10.00 � HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMITr O PRIVATE DISPOSAL SYSTEM @ $3.00 p CONNECTAOO ITIONAL B L...OR AFFIDAVIT WAIVre I18CRIHTRECORD.INSTR.NO. DA E W WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT,GRAINFIELD `0 EXTN.,CESSPOOL.DRYWELL,MANHOLE S5.00 O� Z ALTER,REPAIR OR ABANDON HOUSE SEWER OR DISPOS L PYSTEM @ $3.00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT E z 00 CHARGES AUTHORIZATION TOTAL FEE 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_ OWNEROR NEW HOUSE SEWER OWNERS AGENT ` / , l CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE REAP THIS APPLICATION SEPTIC TANK. FELD IT(5) AND STATE THAT THE ABOVE IE CORRECT AND AGREE TO COMPLY AND/OR BRA INIELD WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ HEREBY CERTIFY THAT I LTER AM PROPERLY REGISTERED AND/OR A ,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA NIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE j �.-„„tom>a B A..FILL SEPTIC TANKS ❑ OF PERMITTEE .991444 ❑ SEEP,PIT<5) ❑ CESSPOOLS VALIDATION ROBERT A. WOOD CK. �/ SUPERVISING MECHANICAL ENGINEER M.O. CpS L&906OG AUG19I I D 25.00-