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Home My Public Portal About9934 LAS TUNAS DR_Sewer__ 76 3-E4 76A642D APPLICATION FOR PERM T A64 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer ADDRESS ct WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST FOR APPLICANT TO FII.L IN CROSS ST ' LEGAL DESCRIPTION LOT NO OWNER MAIL BLOCK TRACT ADDRESS NO OF BLDGS SIZE OF LOT NOW ON LOT CITY TEL NO USE OF BUILDINGS DISTRICT NO GROUP MAP PROCESSED BY .r BK PG CONTRACTOR 1 � I L� `0 71 ADDRESSALD-Z ' / CONNECTION DATA CITY TEL NO 300'? 9 , STATION (� / DEPTH P-3 ❑`--STATE MANHOLE REFERENCE ' UPPER REGISTRATION NO P--� ❑ COUNTY NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FR M HOUSE SEWER CONNECTING TO Y CURB PL M L TO P PUBLIC SEWER SS 00 SEPTIC TANK.SEEPAGE PIT OR P C NO d PITS AND/OR DRAINFIELD @ $1000 CO IMP NO JOB NO O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO V PRIVATE DISPOSAL SYSTEM $3 00 CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVIR EAIEMINT RECORD INSTR NO DATE O WORK TO HOUSE SEWER @ $300 13 0-v- OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN,CESSPOOL DRYWELL MANHOLE @ 55 00 LIJ ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING C. SEWER OR DISPOSAL SYSTEM @ $300 STATE ENCROACHMENT N y y PERMIT NO ` INDUSTRIAL WASTE APPROVAL OWNERS PERMIT S 2 00 CHARGES AUTHORIZATION TOTAL FEE /1 CONNECTION CHARGE FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19` �� l OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK SEEP,PITS) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER REPAIR,SEWER OR , LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABO E DES RI SIDENTI L PR T ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ClOF PERMITTEE' SEEP PIT(S) ❑ CESSPOOLS ❑ VALIDATN ROBERT A. WOOD CK M O SH SUPERVISING MECHANICAL ENGINEER CA 4"2 76A642L APPLICATIO FOR PERMIT 76 A64 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING L ADDRESS �r ' S LOCALITY NEAREST FOR APPLICANT TO FILL IN cRD33 ST LEAL DESCRIPTION LOT NO 6` OWNER A/Ti A1et.1r, 4A MAIL So. BLOCK TRACT ADDRESS NO OF BLDG$ L s"7 1. - /L Zr SIZE OF LOT NOW ON LOT CITY 8 TEL NO vv� USE OF DISTRICT NO GROUP MAP aOCESSED BY BUILDINGSBN PS .- ti ADDRESS 34/70 :SSP' Rl� ✓ ST. CONNECTION DATA C STATION DEPTH CITY O TEL NO ( /7��[J(� / LICENSE NO 3�q CLAS-�ATE LIC S6 �L7 MANHOLE REFERENCE t UPPER LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB P L ML TOP L PUBLIC SEWER SEPTIC TANK SEEPAGE PIT OR P C NOCL PITS AND/OR DRAINFIELD CO IMP NO JOB NO O HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO V PRIVATE DISPOSAL SYSTEM CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIY[II [AS[M[N' RECORD INSTR NO DATE WORK TO HOUSE SEWER a O F OVERFLOW SEEPAGE PIT DRAINFIELD V EXTN CESSPOOL DRYWELL MANHOLE @ W ALTER REPAIR OR ABANDON N6MBE HWY OR ST WIDENING a SEWER OR DISP SAL SYSTEM @ STATE ENCROACHMENT N PERMIT NO z INDUSTRIAL WASTE APPROVAL OWNERCHARGES PERMIT s v 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'S 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 VE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY R ANC ES AND STATE LAWS REGULATING PLUMBIN E R CESSPOOL ❑ DRYWELL ❑ 1 HERE Y CERT Y H I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR SEWER OR LICENSED S R U D BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA R TH I M JEEGALOWNER OF AND INTEND TO DISCONNECT PLUG ANDRESIDE IN, T AB DkSED RESIDENTIAL PROPERTY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMIT EE ❑ SEEP PIT IS) ❑ CESSPOOLS VALIDATJfDN--,, CK M O ( CASH 6 7 7 i-"sEP 8 1 O D 9.0 0 �, , 76A 642D-CE808 A-7/76: ®PPL14 lolN •F•OR P MIT �sl^d•�' CJ r� / [ -SEWER—SEWAGE DISPOSAL A Pr l-4 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FOR'APPLICANT TO FILL IN DISTRICT NO GROUP BK MAP PaI ,BUILDING q C4 3 LAS - ride' JtU� —1 CONNECTION DATA LOCALITY -��•"'�O L � _ NEAREST Ra�� v J STATION �� . DEPTH CROSS ST y 1 "MANHOLE REFERENCE i� OWNER - �0"��• ^ZAP\ �\J TYPE OF TI LENGMAIL Q .� YPL M L TADDRESS C NO. CITY •TEL NO. CO IMP NO .I"JOB NO LEGAL TRUNK PERMIT NO ROAD PERM DESCRIPTION LOT NO J/�, AFFIDAVIT I wAIVEE EAsEM!NTj RECORD INSTR NO DATE BLOCK TRACT /C NO OF BLDGS_ SIZE OF LOT Z!J NOW ON LOT HWY ORST WIDENING USE OF STATE ENCROACHMENT - BUILDINGS PERMIT NO I� [w.' INDUSTRIAL. CONTRACTOR CQaW� I,UE�+� ^E`� Q,�� _`�'KF• WASTE APPROVAL a ADDRESS I l�7 LDS �S.j) PeCHARGES O V p •-� CONNECTION CHARGE FEE CITY STATE hti.1�s0 TEL NO Ip 3'1 (4- TA REIMBURSEMENT FEE 0 LICENSE NO �� T5 Z CLALIC SS L - NO DESCRIPTION OF WORK • 'FEE APPROVALS DATE I NSPECTORR•_S�SIGNATURE a 1 - HOUSE SEWER CONNECTING TO PUBLIC SEWER 10 NEW HOUSE,SEW ER 17-7 N SEPTIC TANK SEEPAGE PIT ,OR PITS AND/OR DRAINFIELD - CONNECT ADDITIONAL HOUSE SEWER CONNECTING TO - BUILDING OR WORK PRIVATE DISPOSAL SYSTEM SEPTIC TANKSEEP,PITIS) ' CONNECT ADDITIONAL BLDG OR -AND/OR DRAIINFIELD - WORK TO HOUSE SEWER OVERFLOW SEEPAGE PIT DRAINFIELD CESSPOOL ❑ DRYWELL ❑ EXTN CESSPOOL DRYWELL MANHOLE 0 ALTER REPAIR OR ABANDON HOUSE ALTER REPAIR SEWER OR SEWER OR DISPOSAL SYSTEM SEWAGE DISPOSAL SYSTEM - DISCONNECT PLUG AND ABANDON HOUSE SEWER ' ` BACKFILL SEPTIC TANKS ❑ SEEP PIT(S) ❑ CESSPOOLS ❑ OWNER'S Issuance Fee s AUTHORIZATION TOTAL FEE ' HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON PLUMBING AND SEWERS TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR TO'THE PUBLIC SEWER LICENSED A:S REQUIRED BY LOS ANGLES'COUNTY AND STATE OF SIGNED THIS DAY OF 19_ CALIFORNIA OR THAT I AM,THE LEGAL OWNER OF, AND INTEND TO OWNER OR RESIDE IN THE ABOV DESCRIBEED RESIDENTIAL PROPERTY OWNERS AGENT SIGNATURE \ _ � ADDRFSq OF PERMTTTEf u VALMATIO CK M,O C- CASH �. r