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HomeMy Public PortalAbout9157, 9157 1/2, 9159 LAS TUNAS DR_Sewer__ DEPARTMENT OF COE1vT% ENGINEER SEWER—SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENINEER BUILDING G ® 1 ADDRESS .-1 15 FICA f FOR APPLICANT TO FILL IN LOCALITY �� c, BUILDING ' NEAREST ADDRESS E, CROSS'ST. LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. /� ✓►��9 � LJ A � NEAREST ,/ / SA• �Z0 irJ CROSS ST. .4 , O #*-,t-7T R CEIVED BY Ready for Inspection DATE ISSUED OWNER "N /9/L�J� L� ZS-. MAIL USE ZONU OCCUPANCY MAP ADDS 7 �•• /�41 ��i7%L� BK PG CITY TEL.NO. / C_ I V=V:L CONTRACTOR - � CO.IMP.N0: I -_) ; ADDRESS ��B O2 77 JOB NO. 1 CITY La�� TEL.N0.4 4<J?l TRUNK PERMIT NO. STATE REGISTRATION NO. �� COUNTY ROAD PERMIT NO. LEGAL DESCRIPTION LOT N0. STATE ENCROACHMENT I I PERMIT NO. . BLOCK TRACT YrR©J INDUSTRIAL WASTEAPPROVAL� �IY�• COajjr /Ir., SIZE OF LOT ( N0.OF BL DGS. �— � I� h NOW ON�gLOT� CHARGES USE OF QG Y G?/J�Jy/�/JEEJ BUILDINGS CONNECT CHARGE FEE ,10. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TOREIMBURSEMENT F PUBLICSEWER @ $ 3.50 5Q RECEIPT NO. TE I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. I DATE I BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2.00 STATION `-} DEPTH ' CESSPOOL—DRYWELL i SPECIAL CONDITIONS ON LY 2.00 Q �1 MANHOLEREFERENCE LOWE _ TYPE OF CONNECTIO LENGTH FROM OWNERS PERMIT = UD - a P.L. M.L.TO P.L. I AUTHORIZATION TOTAL FEE �n SZl I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS��...-. Y OF. NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT--------- ----• BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESSG -...... AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL❑ DRYWELL❑ CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DgSPRIBED RESI�IENNTIIAAL,;�,PROPERTY. BACKFILL SEPTIC TANKS+ SEEP.PIT(S) CESSPOOLS�cSIGNATUR �/ ❑ LTOF PERMITTEE - ... ..'.-. - 76A642A 663 7/53 ® i:s I20 76A642D 0-63 APPLICATION FOR PERMIT - A64 �J COUNTY OF LOS ANGELES SEWER SEWAGE DISPOSAL DEPARTMENT.:OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION . BUILDING J 5— JOHN A. LAMBIE, County Engineer nDDRess WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS 5T. LEGAL DESCRIPTION LOT NO. OWNER _ MAIL / BLOCK TRACT 0 5� ADDRESS 5i 4 (p I NO, OF BLDGS. - 1 A Q` 73 96 SIZE OF LOT p2(y NOW ON LOT CITY NO.. V USE OF DISTRICT NO. G UP MAP PROCESSED BY BUILDINGS BK PG CONTRACTOR �f'$'/ 5;4� PZ L ADDRESS 3 7 ` 4 CONNECTION DATA E I 0�/'�,l STATION DEPTH CITY TEL. NO. /yy STATE MANHOLE REFERENCE UPPER REGISTRATION NO. 1 I �+ ❑ COUNTY LOWER NO. DESCRIPTION OF WORK FEE TYPE OF COh NECTION ENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M. O P.L. d PUBLIC SEWER @ $5.00 SEPTIC TANK,SEEPAGE PIT OR P.C.NO. O CO.IMP. NO. JOB NO. PITS AND/OR DRAINFIELD - @ $10.00 V HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. .PRIVATE DISPOSAL SYSTEM @ $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT RIVE EASEMENT RECORD. INSTR.NO. DATE (— WORK TO HOUSE SEWER @ $3.00 V OVERFLOW SEEPAGE PIT,DRAINFIELD W EXTN.,CESSPOOL,DRYWELL.MANHOLE @ $5.00 n' ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING H SEWER OR DISPOSAL SYSTEM @ S3.00 STATE.ENCROACHMENT PERMIT NO. -INDUSTRIAL WASTE APPROVAL OWNERS PERMIT s 21 00 CHARGE AUTHORIZATION TOTAL FEE T CONNECTION CHARG 'I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSE ENT FEE TRACTOR TOCONNECT 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 .�Mt>t�A 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 PLU MB ING AND SEWERS. LCESSPOOL ❑. 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 SYSTEM CALI.FORN.IA OR THAT I AM THE LEGA�JDENTIND INTEND TO DISCONNECT PLUG AND RESIDE IN, TH BOVE.yDESCRIBBEED RPERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE SEEP,PITS) ❑ CESSPOOLS ❑ ALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK: M.0. CASH L.AGO 0 2 2 6 2 1 0 D 5.00- c