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Home My Public Portal About9094 LAS TUNAS DR_Sewer__ PL C.. - ! T 0-63 76A642D APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS ♦ !� WILLIAM A. JENSEN, Sup't of Building Tc:.MPcE LOCALITY r NEAREST :5 V L FOR APPLICANT TO FILL IN CROSS ST. a - - -_ LEGAL-- - DESCRIPTION LOT NO. OWNER A cv a v {p,/tom t/(T�/`�` O MAIL rip S .7 -. 4// S 7-ON4� BLOCK TRACT f� ADDRESS NO. OF SLOGS. '"' jj /fir r SIZE OF LOT NOW ON LOT CITY I��it /Oc`-JI TEL. NO. A I USE OF BUILDINGS DISTRICT NO. GROUP MAP PRO ED BY Ric CONTRACTOR.9*A4F K�tA i U S j' cL SSS ADDRESS /Iy l; (O.r -_``o CONNECTION DATA CITY ,S TEL. NO. G/ • STATION DEPTH i STATE UPPER REGISTRATION NO. Q 36 COUNTY MANHOLE REFERENCE LOWER No. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LE FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P. } PUBLIC SEWER $5.00 SEPTIC TANK,SEEPAGE PIT OR P.C.NO. d PITS AND/OR DRAINFIELD 510.00 CO.IMP.NO. JOB NO. O HOUSE SEWER CONNECTING TO TRP 1 � 7 RMIT NO. U PRIVATE DISPOSAL SYSTEM 111 $3.00 Q' CONNECT ADDITIONAL BLDG.OR o AFFIDA 1 wAIV E EASiNC T R CORD.INSTR.NO. DATE Q WORK TO HOUSE SEWER @ $3.00 U OVERFLOW SEEPAGE PIT,DRAINFIELD 1 W EXTN.,CESSPOOL,DRYWELL.MANHOLE @ $5.00 D. ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING 1n SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT Z PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNER'S PERMIT s 2 00 AUTHORIZATION TOTAL FEE O V CONNECTION L`HA RGE FEE 'I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE ARTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TOTHEPUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL P _ ADDRESS_ BUILDING OR WORK 1.'y I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(5) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND 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 RES�L PROPERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP.PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK/ M. O. CASH LACO 93426 IM2'71 0 D 5.00" F ( °-69 76A642D APPLICATION FOR PERMIT 6A642 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING G JOHN A LAMBIE, County Enggineer ADDRESS D -/ �/ /E . 4A6 'TJ/`/ WILLIAM A. JENSEN, Sup't of Building LOCALITY �'. ✓ Lh �f T NEAREST FOR APPLICANT TO FILL IN CROSS ST LEGAL y, ^ n DESCRIPTION LOT NO OWNER /!a� AJ MAIL BLOCK TRACT ` n 1 01 ADDRESS v S e � 5 �(��,'{,p NO OF SLOGS /� SIZE OF LOT NOW ON LOT CITY J C� NOA 79 7 USE OF BUILDINGS DISTRICT NO GROUP BK PG MAP BY '�� CONTRACTOR ✓' L� ♦ �r`�( J�"�` 1,,PROCESSED ^ ADDRESS CONNECTION DATA CITY ! TEL NO /Y (f Z9 ,0 7 STATION DEPTH STATE UPPER REGISTRATION NO ® MANHOLE REFERENCE COUNTY LOWER NO DESCRIPTION OF WORK FEE TYPE F ONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y y CURB PL ML TO P L a PUBLIC SEWER @ $5 Do r SEPTIC TANK,SEEPAGE PIT OR COL+b,a P C NO O PITS AND/OR DRAINFIELD $1000 CIM NO NO V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO w PRIVATE DISPOSAL SYSTEM $3 00 0 CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVER EASEMENT RECORD IN5TR NO DATE V{,. WORK TO HOUSE SEWER @ $3 00 U OVERFLOW SEEPAGE PIT DRAINFIELD l!J EXTN,CESSPOOL,DRYWELL MANHOLE @ $5 00 ALSF -OR ABANDON HOUSE HWY OR ST WIDENING N SEWER OR-D4S4LOSASEM @ $300 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ 2 00 AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE IHAVE 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 5 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 PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSEDAS REQUIRED 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 ABOV DESCRIBED RESIDEN ALP PERTY ABANDON HOUSE SEWER SIGNATURE A BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK M O CASH 9 5 6 3 ,AIN 1 1 0 D Jc.0 0- w C E808 10-63 76A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION F NG JOHN A. LAMBIE, County Engineer SS Q / �/ J� - 4,46 TU/`/ WILLIAM A. JENSEN, Sup't of Building ITY ST (FOR APPLICANT TO FILL IN ST. 's 1 LEGAL J) T� DESCRIPTION LOT NO� - OWNER RQL*Ale'�f A) V1/ - BLOCK TRACT ADDRESS 0/ S • l j �(J/ls N0. OF BLDGS. r ff' SIZE OF LOT NOW ON LOT CITY �/— J IE G/ . NO. 7 USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS BK PG 71 CONTRACTOR r D Z Z �' '- •+' • ` C! ADDRESS CONNECTION DATA CITYTEL. NO. JV v Z17-07 STATION DEPTH STATE MANHOLE REFERENCE UPPER REGISTRATION NO. LJ COUNTY LOWER NO, DESCRIPTION OF WORK FEE TYPE F ONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. qCUR P.L. M.L.TO P.L. d PUBLIC SEWER $3.00 / SEPTIC TANK,SEEPAGE PIT DR L/ NO. O PITS AND/OR DRAINFIELD @ $10.00 -CO.IM NO. NO. U HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. IX PRIVATE DISPOSAL SYSTEM $3.00 0 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT I WAIVER IASIMINT RECORD.INSTR.NO. DATE �. WORK TO HOUSE SEWER @ $3.00 U OVERFLOW SEEPAGE PIT,DRAINFIELD LlJ EXTN.,CESSPOOL,DRYWELL.MAN HOLE $5.00 ALrc---- oR ABANDON HOUSE HWY.OR 5T.WIDENING N SEWER OB�&:SSEM $3.00 STATE ENCROACHMENT IL PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNER"S PERMIT $ z 00 AUTHORIZATION I TOTAL FEE _. CONNECTION CHARGE FEE '1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER. 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,PITS) 1 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 CESSPOOL ❑ DRYW ELL ❑ PLUMBING AND SEWERS. 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR 3 LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM •j CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND - - RESIDE IN, THE ASO V DESCRIBED RES IDEN AL P PERTY, ABANDON HOUSE SEWER SIGNATURE q f,�� •"�' BACKFILL SEPTIC TANKS ❑ OF PERMITTEE �'!� ///'�� SEEP.PIT(S) ElCESSPOOLS ❑ �_��v✓ /✓� /?��z _ VALIDATIOC�--/ ROBERT A. WOOD CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER 95631 M 1 1 O D 5.00-