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Home My Public Portal About10520 LIVE OAK AVE_Sewer__ DEPARTMENT OF COUNTY ENG NEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX, COUNTY ENGINEER 'j BUILDING s-1a //��• �� ADDRESS l(/ YG LOCALITYfb NBUILDINGEAREST ADORE CAN'T TO FILL IN AO RESS • � �`V 1� 0A CROSS ST. /�J X LOCALITY AA�I A -DISTRICT NO.' SERIAL NO. PERMIT NO. NEAREST A T�"�� S CROSS ST LA ((l1 jj�� w REECSCE•IVEO-BYR Ready for Inspection /D/AT``E ISSUED a OWNER 1'L w U o2 1 ! } /s9 � ' I /9-/S! MAIL ADDRESSr USEZONE I OCCUPANCY BrIGMAP CITYjQ10 LI 44 . vd� ;ec e=. CONTRACTOR /�•� CO.IMP.NO. / ! ADDRESS / !R!i05 j�y�iL JOB.N0. s CITY �l� TEL.NO. TRUNK PERMIT NO. REGISTRATION N0. l�Sb C-Z? 5: COUNTY ROAD PERMIT NO. - LEGAL � T STATE ENCROACHMENT DESCRIPTION LOT NO. 1 �� ? PERMIT NO. BLOCK � TRACT e, �GD j WASTE APPROVAL SIZE OF LOT �� NO.OF BNOW ON LOTS CHARGE USE OF f BUILDINGS CONNECTION CHARGE EE ` N0. DESCRIPTION OF WORK FE J REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO / PUBLICSEWER @ $ 3.50 Q RECEIPT NO. I� DATE I BY HOUSESEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR -XCEPTI311 RECORDED WORK TO HOUSE SEWER 1.00 D No. DOTE I BY • ALTER OR REPAIR EXISTING A,p SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER , AND/OR DISPOSAL SYSTEM 1 00 CONNECTIOOE)ATA —SEPTAN TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD � 2.00 STATION DEPTH CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE, UPPER LOWER �jl _TYPE OF CONNECTION LENGTH LENGTH FROM OWNERS PERMIT I OO � P M L.TO P.L. 45 AUTHORIZATION I TOTAL FEE p 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-------7--------DAY OF----------L�_I!-_---------- NEW HOUSE SEWER' OWNER OR CONNECT ADDITIONAL OWNERS AGENT- --- � � BUILDING OR WORK L � SEPTIC TANK,SEEP.PIT(3) ADDRESS-j-6-T--_..-..- _-._------_- AND/ORDRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[] ORYWELL 0-- 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 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE S EWER AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ER OF THE ABOVE DESCRIBED_RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS ,��•• SEEP.PIT(S)E] CESSPOOLS Ek. YD C, SIGNATURE F Y ,�, j ---------_.------ OF PERMITTEE--- -- ------------------- -_ i 6A642D 663 1/53 6A642-62 7D APPLICATION FOR, PERMIT 6A642 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ✓/ /J + ,ry JOHN A. LAMBLE, County En D Engineer ADRESS 8 C� WILLIAM A. JENSEN, Sup't of Building LOCALITY NEAREST FOR APP C NT TO FILL IN CRDSB BT LEGAL / DESCRIPTION P LOT NO L' qw- 3 OWNER l MAIL ,... I • r �. BLOCK TRACT Q ""''I�' ADDRESS /� lam• /NOOF BLOGS �j - SIZE OF LOT NOW ON LOT v CITY � 7 TEL NO USE OF DISTRICT NO GROUP MAP 'PROCESSED BY BUILDINGS /PG CONTRACTOR ADDRESS '7-; j �y CONNEC ON DATA t {� [/ /-7 / CITY TEL NO Z STATION DEPTW,' / REGISTRATION NO STY ATE MANHOLE REFERENCE / COUNT � NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION -LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB L ML TOPIL PUBLIC SEWER (it $5 00 NO SEPTIC TANK,SEEPAGE PIT OR P C PITS AND/OR DRAINFIELD @ $10 00 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO TRUNK P IT ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ $3 00 CONNECT ADDITIONAL BLDG OR A17:t,EASEMENTLMECORD INSTR NO DATE WORK TO HOUSE SEWER @ $300 (4O / OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @) $5 00 ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING SEWER OR DISPOSAL SYSTEM @ $3 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMITs z o0 AUTHORIZATION I TOTAL FEE CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF 19� OWNER OR �'h ✓_ , \ NEW HOUSE SEWER OWNERS AGE / CONNECT ADDITIONAL ADDRESS—" (J:-� BUILDING OR WORK ' l v _ SEPTIC TANK SEEP,PIT(S) G _ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS 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 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 RESIDENTIZ PROPERTY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE ❑ SEEP PIT(S) El CESSPOOLS VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK M O CASH L;VLo 1 21 5 3 GO FEB 21 1 0 D CL