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Home My Public Portal About10642 LIVE OAK AVE_Sewer__ -62 APPLICATION FOR PERMIT 76A642D - 6A642 - COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, County Engineer !DD RESS WILLIAM A. JENSEN, Supt of Building r , r • LOCALITY NEAREST I FOR--APPLICANT•�(JTO FILL IN OSS ST LEGAL l/Ut y,5 DESCRIPTION LOT NO M L BLOCK- CT ,� AD RE5 - NO OF BLDGS SIZE OF LOT NOW ON L T CITY TEL NO USE OF - DISTRICT NO GROUP MAP ' PROCESS 9Y BUILDINGS CONTRACTOR O BK PG AM ADDRESS CONNECTION DATA CITY TEL NO STATION Q %1 ♦,DEPTH p�.I{ STATE �J UPPER REGISTRATION NO IJ COU ryTY MA E ERE LOWER NO F DESCRIPTION OF WORK FEE TYPE O CONNE I N CEN TH F OM HOUSE SEWER CONNECTING TO Y CUR PL T PUBLIC SEWER @.$5 00 SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $1000 CO IMP O NO111 V HOU 5 ESET � ROAD PERMIT ERCONNECTINGTO T R U N K P E RAD PERMIT PRIVATE DISPOSAL SYSTEM @ S3 00 CONNECT ADDITIONAL BLDG OR - AFFI IT w.lY[R rASEM ENT RECORD INSTR�O DATE 'WORK TO HOUSE SEWER @ $3 00 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE @ $500dmmccmU"r ABANDON HOUSE - HWY OR ST WIDENING SEWER OR_0416�SYSTEM @ $300 STATE ENCROACHMENT b ' PERMIT NO _ INDUSTRIAL- .. 9 " - — WASTE APPROVAL 'CHARGES OWNERS PERMIT $ 2 00 AUTHORIZATION I 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 - - OWNER OR o 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 IS CORRECT AND AGREE TO COMPLY WITH ALL COU ORDINANCES AND STATE LAWS REGULATING - PLUMBING'AN SE RS CESSPOOL ❑ DRYWELL ❑ I HEREBY ERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ALTER REPAIR SEWER OR LICENSED AS REOUIR BY L A LES•COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA R THAT 1 TH E OWNER OF AND INTEND TO RESIDE IN, TH ABOV SCR ED R IDEN L PROPERTY DISCONNECT PLUG AND / t� ABANDON HOUSE SEWER 'SIGNATURE- — OF PERMITTEE BACKFILL SEPTIC TANKS E]SEEP PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD CK m o CASH SUPERVISING MECHANICAL ENGINEER LACO 6 3 0 0Q.1 OCT 31 1 0 D 5.0 0- a CEB083-62 76A842D; APPLICA IOM FOIPRMIT ll COUNTY OF LOS ANGELES SEWER 'SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISIONBUILDING O � � Y, JOHN A. LAMBIE, County Engineer ADDRESS V WILLIAM A. JENSEN, Sup't of Building r` _ LOCALITY O �•�o NEAREST FOR APPLIC T TO IN `ROSS ST LEGAL �a / DESCRIPTION LOT NO / OWNER ^/y_� �/✓� MAIL / R•'"{� BLOCK TRACT I/J� /�j �� 6O ADDR E55 �p NO OF SLOGS SIZE OF LOT NON%,ON LOT CITY 1;;:�2I TEL NO USE OF DISTRICT NO GROUP MAP PROCESSED BY BUILDINGS L /� �• /jP BK PG CONTRACTO e r7. /^ Af ADDRESS3 DATA ' CITY � a� TEL STATION DEPTH TA/TEE MANHOLE REFERENCE - UPPER �j REGISTRATION NO (, COUNTY LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM -HOUSE SEWER CONNECTING TO Y CURB P L _ML TO P L O PUBLIC SEWER @ E5 00 PC NO SEPTIC TANK SEEPAGE PIT OR CO IMP NO JOB NO V PITS AND/OR DRAINFIELD @ $1000 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM @ 3300 _. CONNECT ADDITIONAL BLDG-=. AFFIDAVI WAIVER EASEMENT RECORD IN R O DATFrI, f0 HOUSE SEWER E &0 3 00 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL,DRYWELL MANHOLE @ $500 ALTER,REPAIR OR ABANDON HOUSEHWY OR ST WIDENING SEWER OR DISPOSAL SYSTEM @ $300 STATE ENCROACHMENT PERMIT NO INDUSTRIAL ' W TE APP OVA OWNERS PERMIT $ 2 Oo AUTHORIZATION TOTAL FEE � , .'NNE TION CHAR FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT F E TRACTOR TO CONNECT THE ABOVE D SCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY 19_ - OWNER OR NEW HOUSE SEWER ) At OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK _ 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 PLUMBING AND SEWERS - CESSPOOL ❑ DRYWELL ❑ I HEREBY CE HAT I AM PROPERLY REGIST RED AND/OR ALTER REPAIR SEWER OR LICENSED A REQUIRE BY LOS ANGLES COUNTY NO STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNI OR,THAT AM THE LEGAL NER OF, ND INTEND TO DISCONNECT PLUG AND RESIDE I THE ABO DESI.RIBED R IDENTIAL OPERTY ABANDON HOUSE SEWER SIG NATU - OF PER BACKFILL SEPTIC TANKS ❑ SEEP PIT IS) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD K SUPERVISING MECHANICAL ENGINEER _ M O CASH LACo 7 0 's 8 NOV 16 1 0 D 5.00-