HomeMy Public PortalAbout9818 LAS TUNAS DR_Sewer__ 76A6420-65 APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
BUILDING AND SAFETY DIVISION BUILDING
JOIEN A. LAMHT!':, CLwnty EnginetIr
COI.MllN jpl'.\KINS,Supt. of BuiMing
FNEAREST
FOR APPLICANT TO FILL IN CROSS ST._(.,, A
r
_PESCRI�TION LOT_NC. OWNER Cc-
1.4
AIL 0
_BLOCK TRACT ADDRESS
NO. OF 13L D GS. TEL, NO.Z'4
SIZE OF LOT NOW ON LOT CITY
USE
BUILDINGS DISTRICT NO. GROUP MAP PROCESSED 13Y
BK PG
CON' CTO
ADDRESS CONNECTION DATA
CITY TEL NO. STATION DEPTH
LICENSE LICENSE-- PPIER
NO. C LA 55 MANHOLE REFERENCE / /:- /. "', {/-.-
- / LOVER--_
--I--ESiC-
No E� RI Pflb�4 OF WORK FEE _ --TYPE-OF-CONNECTION LENGTH FROM
�NOUSF. SEWER CONNF CT LNG TO Y. CURB
-LPUBLIC SEWER 5.00
NO.
GE- OR IMF.NO. JOB 9L
1TS AND/OR DRAINFIELDIT NO.P $1-000 0
ER-fff TAW, SF E�PA
P
HOOSE SEWER CONNFCTING TO TRUNK PERMIT NO. ROAD PERMIT NO. u
PRI VANE DISPOSAL SYSTEM 3.001
Z-dAFFIDAVIT WATViR--FTAsimiWTJ RECORD. INSTR.NO T ce
-N-N ff-C T ADOD I T-56NA L B
WORK TO HOUSE SEWER 3.001 0
HOUSE
OR a's PIOIS.Cv IS y 5 1 F M $ 3.00
77RWMTT=.----t- ---- HWY.OR ST,WIDENING
I o vr-R r SE (3 r-PTT-
EXTN.,CESSPOOL, MAN $ 5.0 - -
14 0-------- -
- STATE ENCROACHMENT
1 PERCOLATION TEST $ 5.001 _PERMIT NO.
INDUSTRIAL
WASTE APPROVAL
CHARGES
OWNER'S 2-f-o-o-
j AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE
I HAVE
AT THIS DATE A CONTRACT WITH THE HEREIN NAMED --ON- REIMBURSEMEf�TFEE
T RACTOR T ONNECT THE ABOVE DESCRIBED EXISTING DWELLING 0 C
TO THE PUBLIC SEWER. APPROVALS _ DATE NATURE
SIGNED THIS_-DAY
OWNER 1111 NEW HOUSE SEWER
OWNERS AGENT_
CONNECTADDITIONAL
BUILDING
UILDING OR WORK
ADDRESS.____-_.,__ ......
SEPTIC TANK,SEEP,PIT(S)
I HFREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AN./OR DRAINFIELD
ANDSTATE THAT THE ABOVE 15 CORRECT AND AGREE TO
COMPLY
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING
PLU MB;NG AND SEWERS. CESSPOOL El DRYWELL El
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR
LICENSED AS REQUIRED-,PY LOS A6WLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM
HE LElf-L'VWNER Of, ANP INTEND TO DISCONNECT PLUG
CALIFORNIA I FORNIA DR THAT I 111M S 11
RESIDE
I IN THE A.."
I F -�IAL�VROPkRTY. SEAN
ES DE I ED IDEN ABANDON HOUSE SEWER Z
y,
SIGNATURE
OF PERMITTEEBACKFILLS E PTIC TANKS El
(
SEEP,PIT S) ❑ CESSPOOLS E]
VALIDATION
C M.O. CASH
J.
9 3'S 1 7 1 0 5.00
DEPARTTHENT OF COUNTY ENGINEER SEWER--SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS LOCALITY ( a -----
FOR APPLICANT TO FILL IN -
BUILDING - NEAREST
ADDRESS td .Br�T -11vL�is+-�1 '9 CROSS ST. a
LOCALITYt DISTRICT O. SERIAL NO. PERMIT NO.
.7,7
NEAREST � / _
A S
CROSS ST. K—Z,4 ism RECEIVED BY ,� Ready for Inspection DATE ISSUED
OWNER
MAIL RESS Z / t USE ZONE CCUPANCY MAP
ZL1✓L+CC� Vrj ty i� I BK PG
CITY£1V 'Cie TEL.NO.�-� �� � iid� � {� O �
CONTIMOTO Nottingham f:!1_ of SII Cal. CO.IMP.NO. l
ADDRESS 5933 N. CLCVERLY AVE. JOB.NO.
CITY TEMPLE CITY, (A I!fM.
(�'STATE
tT ❑ TRUNK PERMIT NO.
REGISTRATION NO. 7COUNTY POAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT NO.
BLOCK TRACT •:;/ INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT.3?' fi .. ON LOTS CHARGES
NOW
USE OF r. !i CONNECTION CHARGE FEE
BUILDINGS
NO. DESCRIPTION OF WORK F E REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TOPUBLIC SEWER 0 $ 3.50 '. RECEIPT NO. I DATE (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. DATE BY
—_SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
_AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR r
PITS AND/OR DRAINFIELD 2.00 STATION y1. DEPTH
CESSPOOL—DRYWELL , y`--
SPECIAL CONDITIONS ONLY 2.00 Ai 1 T MAI8iEEREFERENCEiUPPR
LOWER
TYPE.O TION LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERS PERMIT f I Il 00
AUTHORIZATION TOTAL FEE14
' —
1 HAVE THIS DATE CONTRACTED WITH THE HERE N NAMED
CONTRACTOR TO CONNECT THE A.POVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO TH 1 W
NEW HOUSE SEWER {'
SIGNED TH{5..�.,1 OF , .r.�+��r.�YA.'a...�'t
OWNER OR /,fiy CONNECT ADDITIONAL
OWNERS AGEN�/�:. _ �fr_ BUILDING OR WORK
r j LiJIJel,Gf2�f SEPTIC TANK,SEEP.PIT(S)
ADDRESS--- ....__.- .. .- ..t... AND/ORDRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP CESSPOOL[] DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AG E
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS El (
SIGNATURE C. NOTTtNGNAM CO. OF , CAL. SEEP.P,T(S) CES8POQLS Cf" / p1R-i sem=, z ` TM
OF PERMITTEE _- .__-