HomeMy Public PortalAbout9414, 9412 LAS TUNAS DR_Sewer__ CE808- -a•sa- - APPLICATION FOR PERMIT . ' ... -
eaoe- COUNTY OF LOS ANGELES _ 'SEWER-SEWAGE DISPOSAL
DEPARTMENT OF.COUNTY ENGINEER-
BUILDING AND SAFETY DIVISION BUILDING 'rClj1/A -
JOHN A. LAMBIE, County-Engineer' ADDRESS
CASSATT D. GRIFFIN,Sup't of Building LOCALITY
FOR APPLICANT TO FILL IN NEAREST .
�J CROSS ST.
'LEDESCRIPTION LOT NO. /
OWNER
MAIL
BLOCK TRACT t/ 9 rf�, ADDRESS J 1L,
NO.OF BLDGS:
SIZE OF LOT' k NOW ON,LOT I CITY TEL.NO.
USE OF �KM
BUILDINGS DISTRICT NO. GROUP MAP PROCESSED BY
I
CONTRACTOR 2� BK /47 Is
4
ADDRESS f 5-j CONNECTION DATA
CITY �.� .. TEL. NO.Z.Q (yA-1 C.P Com. STATION DEPTH
STATE
REGISTRATION NO. ® COUNTY MANHOLE REFERENCE � UPPER
LOWER.
NO. DESCRIPTI OF WORK FEE
HOUSE SEWER CONNECTING TO
<,
PUBLIC-SEWER' - —•, -@ $3:00 - -
SEPTIC TANK,SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM
PITS AND/OR DRAINFIELD @ $3,00 Y. CURB F.L. M.L.TO P.L.
OVERFLOW SEEPAGE PIT, DRAINFIELD
EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00
HOUSE•SEWER CONNECTING TO P.C, 0.
PRIVATE DISPOSAL SYSTEM @ $1.00.' CO.1MP.NO. - JOB NO.
CONNECT ADDITIONAL BLDG.OR �^1 TRUNK PERMIT NO., ROAD PERMIT NO.
WORK TO HOUSE SEWER @ $1.00 Q V
ALTER,REPAIR OR ABANDON HOUSE STATE ENCROAS,EiME�ITSEWER OR DISPOSAL SYSTEM @-$1.00 PERMIT NO., iez! .Ei4 (L/
INDUSTRIAL ,,,, /
WASTE APPROVAL�it�l -� J
CHARGES
OWNER'S PERMIT $ ,2 00 CONNECTION.CHARGE FEE
AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. [.ALTER,-
APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO -CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER.
SIGNED THIS DAY OF - 19— HOUSE SEWER
OWNER OR OWNERS AGENT DING OR WORK. I 1.4NECT ADDITIONALr, r--�
C TANK,SEEP,-PITS)
ADDRESS OR DRAINFIELD _
I HER EBY'ACKNOWLEDGE THAT f HAVE READ THIS APPLICATION - -
AND STATE THAT THE'ABOVE IS CORRECT AND AGREE TO COMPLYPOOL❑ DRYWELL_❑ - -
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGREPAIR,SEWER ORPLUMBING AND SEWERS. GEDISPOSAL-SYSTEM
1 HEREBY CERTIFY THAT I AM PROPERLY. REGISTERED AND/ORNNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND-STATE OFDON HOUSESEWER
CALIFORNIA OR TH I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDEN A PROPERTY. FILL SEPTIC TANKS❑SIGNATURE
PIT(S) ❑ -CESSPOOLS❑
OF PERMITTE
®r VAIIDATIO ROBERT A..WOOD
Cg,
X.0. "69 V SUPERVISING MECHANICAL ENGINEER
18A6420 APPLICATION MR PERMIT-
S&E-683 Di1.55 -IVISION OF BUILDING AND SAFETY SEWER-SEWAGE :DISPOSAL ..
Department of.County -Engineer
County of Los Angeles aooIL aESSG
JOHN A. LAMBIE, COUNTY ENGINEER
® .CASSATTD.'GRIFFIN, SUP'TOF.BUILDING LOCALITY ZeH A4.4 C,(r
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. A
LEGAL OWNER
DESCRIPTION-- LOT NO. / -
MAIL
BLOCK TRACT ADDRESSNO.OF BLDGS.
SIZE OF LOT SOX/TO NOW ON LOT Z^D CITY c - TEL. N0.
�"S
USELDINGS OF DISTRICT NO. - GROUP ' MAP
I BK PG
CONTRACTOR 147
CONNECTION DATA
ADDRESS
�J� e STATION - - DEPTH
-.CITY TEL. NO. 1.zp--(�' -
= MANHOLE REFERENCE -- � -- - - � _ - - .UPPER-
`� ❑ STATE 1 LOWER
.�S
REGISTRATION NO, ❑ COUNTY
NO DESCRI.P-T.I. .N_OF._WO K ,_�- -FEI!_ _ _ _
- - --TYPE-OF"CONNECTION `"- -LENGTH-'F
HOUSE SEWER CONNECTING TO M.L.TO P.
PUBLIC SEWER @ $3CURB P.L. L.
.50 -
SEPTIC TANK,SEEPAGE PIT OR -
PITS AND/OR DRAINFIELD @ $3.00 _
OVERFLOW SEEPAGE PIT, DRAINFIELD P. C. o. - - -
EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 . CO. IMP, N 70B N0. -
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NAD.PERMIT NO.' - -
CONNECT ADDITIONAL BLDG.OR STATE ENCROACHME
WORK TO HOUSE SEWER @ $1.00 PERMIT NO. '
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL - -
SEWER OR DISPOSAL SYSTEM @ $1.00 WASTE APPROV
C RGES
NNECTION CHARGE FEE
OWNER`S PERMIT $ i 00
AUTHORIZATION TOTAL FEE �!rRE MBllRSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED COM-` "" APPROVALS DATE INSPECTOR'S SIGNATURE -.
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING ,�. - -
TO THE PUBLIC SEWER. _EW HOUSE SEWER -
SIGNED THIS DAY OF19 CONNECT ITIONAL
OWNER OR /Rq F -• BUILDING1A�D,DWORK
OWNERS AGENT - - 7/V SEPTIC TANK,SEEP,PIT(S) 1� r
ADDRESS AND/OR DRAINFIELD- _
1 HEREBY ACKNOWLEDGE THAT'I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT. AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES .AND STATE_ LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. - SEWAGE DISPOSAL SYSTEM r
I HEREBY CERTIFY.THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT.PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE -
DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS'❑,
SIGNATURE If e SEEP. PIT(S) ❑ CESSPOOLS❑
OF PERMITTEE -
JOHN A. LAMB E, COUNTY ENGINEER VALIDATIO ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
CK. W 0.
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