Loading...
HomeMy Public PortalAbout9519-9521 LAS TUNAS DR_Sewer__ a `68°8 '2.88 76A 642D APPLICATION' FOR PERMIT COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION rEUIL NJOHN A. LAMBIE. COUNTY ENGINEER 453 DDRCOLEMAN W. JENKINS. SUPT. OF BUILDING OCALITY NEAREST FOR APPLICANT TO FILL IN CRo$B BT. LEGAL M, DESCRIPTION LOT NO. n OWNER 1W , ' pdyvEzl BLOCK TRACT MAIL�• ADDRESS NO. OF .BLOCS. S12E OF LOT UOW ON LOT CI TEL. NO. USE OF BUILDINGS DISTRICT NO. GROUP MqP PRO SSED BY BUILD SK PG CONTRACTO 0 , G !!4� A - f ~ ADDRES CONNECTION DATA DATA CITY �rr a TEL. NO. STATION 7.-,A,9-3 DEPTH STATE LIC (� UPPER LICENSE NOCLA'SS j�t MANHOLE REFERENCE NO. I DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB .L. M.L.TO P.L. PUBLIC SEWER @ $5.00 SEPTIC TANK.SEEPAGE PIT OR P.C.NO. PITS AND/OR DRAINFIELD @ $10.00 CO.IMP. NO. .JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM 83.00 CJ CONNECT ADDITIONAL BLDG.OR AFFIDAVIT *AIVEE I EASEr ENT RECORD.INSTR.NO. DATE U WORK TO HOUSE SEWER @ $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD O EXTN"CESSPOOL.DRYWELL.MANHOLE @ $5.00 LTER.REPAIR OR ABANDON HOUSE HWY,OR ST.WIDENING LU SEWE OR DISPOSAL SYSTEM @ $3.00 A STATE ENCROACHMENT •- PERMIT NO. Z INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT s 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A .CONTRACT WITHTHE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO-CONNECT THE ABOVE DESCRIBED EXISTING DWELLIN TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR�WORK 1 HEREBY ACKNOWLEDGE THAT,I HAVE READ THIS APPLICATION' SEPTIC TANK,SEEP,PIT(S) AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ IHEREBY C RTI FV THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAI R.SEWER OR LICENSED AS OUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA O THAT 1 qM TH4 LEGAL O NER OF AND INTEND TO DISCO LUSz AND RESIDE IN, TH ABOVE DESCRIBED REST NTIAL OPERTY, ryDON NOUS SIGNATURE BACHFILL SEPTIC TANKS ❑ OF PER MITTE SEEP.PIT(S) [:] CESSPOOLS ❑ LIDATION JACK R. ALLEN CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER f';6 8.2 6: SEP 18 1 0 D 5.0 0 ` 786AA 642D 642D-°" APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 91rd A10--f COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY Ae_ NEAREST FOR APPLICANT TO FILL IN CROSS ST. G LEGAL h DESCRIPTION LOT NO. OWNER! / y MAIL BLOCK TRACT ADDRESSh �! NO. OF BLDG$. /� SIZE OF LOT NOW ON LOT CITY ' A e" EL. NO. USE OF / / DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS Ci 4r� /9 SK PG CONTRACTOR .4'A4' ADDRESS /G rt� (/ CONNECTION.DATA CITY �(/ '/ NO.' %� STATION �yr� -3DEPTH STATE LI MANHOLE REFERENCE _ PPER LICENSE NO. CLASSo 7 �i-- LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM J HOUSE SEWER CONNECTING TO D Y. CURB P.L! M.L.TO P.L. PUBLIC SEWER @ $5.00 SEPTIC TANK.SEEPAGE PIT OR /�� !' P.C.NO. PITS AND/OR DRAINFIELD $10.00 CO.IMP. NO. J� JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. D_ PRIVATE DISPOSAL SYSTEM @ $3.00 C=) CO ADDITIONAL BLDG.OR AFFIDAVIT I WAIVER EASEMENT RECORD.INSTR.NO. DATE IJ WORK TO HOUSE SEWER @ $3.00 C= OVERFLOW SEEPAGE PIT.DRAINFIELD O EXT N..CESSPOOL.DRYWELL.MANHOLE @ 85.00 ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING W SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT CL. PERMIT NO. INDUSTRIAL WASTE APPROVAL OWNERS PERMIT $ z 00 CHARGES AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE ACONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TOA THERPU BLIIC SEWER THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ N !' . OWNER OR NEW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(5) 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 CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER.REPAIR.SEWER OR LICENSED AS REOUIRED 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 DESCR;l B7ZIDTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE "- SEEP.PIT ISI ❑ CESSPOOLS ❑ VAIMATIO JACK R. ALLEN CK. M.0. CASH SUPERVISING MECHANICAL ENGINEER cm I.ACh6 9 6 9" S&29 1 0 D 7.00~ D ISa E-683 f 1.55 APPLICATION FOR PERMIT 1 S&E•6 DIVISION OF BUILDING AND SAFETY -SEWER-SEWAGE DISPOSAL Deportment of County Engineer County of Los Angeles BUILDING JOHN A. LAMBIE,COUNTY ENGINEER ADDRESS ��/ " f' _j�/ ,�yc;,x,j; _,.-r'•. ® CASSATT D. GRIFFIN, SUP"r OF BUILDING LOCALITY FOR APPLIC>AJNT TO FILL IN CROSS ST.LEGAL 4- DESCRIPTION LOT NO. ,�-. r� OWNERMAI L BLOCK TRACT _ f ADDRESS NO.OF BLDGS. 1 CITY' 4!5Z TEL. NO. SIZE OF LOT NOW ON LOT USE OF BUILDINGS DISTRICT N0. GROUP I MAP ' r� BK PG CONTRACT ADDRESS CONNECTION DATA CITY C ! TEL. No. l STATION DEPTH �7 ❑ STATE //r/ MANHOLE REFERENCE q [, PER REGISTRATION NO, �/�is `-�'•'Vo .j]—C;3»V`TY - f NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION. LENGTH FROM / p HOUSE SEWER CONNECTING TO Y. CURB P.L.`) M.L. TO P.L. / PUBLIC-SEWER @ $3.50 SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD l � JOBC.N O EXTN.,CESSPOOL,DRYWELL,MAN HOLE @ $2.00 CO. IMP. NO. , HOUSE SEWER.CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT N0, ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT WORK TO HOUSE SEWER @ $1.00 PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR'DISPOSAL SYSTEM @ $1.00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ ::; - 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING s..- TO THE PUBLIC SEWER. NEW HOUSE SEWER t� SIGNED THIS /SDA 19 CONNECT ADDITIONAL OWNER OR / •� �� BUILDING OR WORK OWNERS AGENT /// V SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKN WLEDGE 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 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STAT E OF ABANDON DISCONNECT CT PLUG PLUGHOUSE AND CALIFORNIA OR THAT I AM THE LEGAL OW.N-E' THE ABOVE WER DESCRIBED RESIDENTI PROPER X. / BACKFILL SEPTIC TANKS❑ SIGNATURE E �-`r� j G,�;•' //_. J SEEP. PITS) ❑ CESSPOOLS❑ OF PERM ITT F/%/���/ ?!' C•C�-'V JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR CK.l M. 0. CASH }1i�©s 2 r ��31 .4 4.5 0, Ll