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Home My Public Portal About9619 LAS TUNAS DR_Sewer__ 73 � ,o`7' :66.66 5-65 16A 642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNE-AREST JOHN A. LAMBIE, County Engineer COLEMAN W. JENKINS.Sup't. of Building FOR APPLICANT TO FILL IN . LEGAL DESCRIPTION LOT NO. / OWN tj�L12•/ MAIL BLOCK TRACT ® ADDRESS �J3 / SIZE OF LOT NOWOO ON LTS CITY c TEL. N V"e / 7r . USE OF BUILDINGS DISTRICT NO. GRO MAP PROCESSED BY BK PG ADDRESS CONNECTION DATA TEL. NO "-LJ�� STATION E LICENSE LICENSE (/ UPPER NO. 7W-7 CLASS MANHOLE REFERENCE LOWER NO. DESCRIPTI N OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER C $ 5.00 P.C.NO. >_ PI TANK, SEEPAGE PIT OR CO.IMP. NO. JOB NO. 0 PITS AND/OR DRAINFIELD C $10.00 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. U PRIVATE DISPOSAL SYSTEM C $ 3.00 CONNECT ADDISTIONAL BLDG. OR AFFIDAVIT WAIVER EASEMENT RECORD,INSTR,NO, DATE 0 WORK TO HOUE SEWER C $ 3.00 ABANDON HOUSE l A Gi�WGY�6I�O ISPOSL SYSTEM @ $ 3.00 Q(' YYYJJJJ HWY. OR ST,WIDENING a EX T N.,CE S S POOL, MANHOLE @ $ 5.00i� STATE ENCROACHMENT H I PERCOLATION TEST C $ 5.06 PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT S 2 00 AUTHORIZATION I TOTAL FEE 0 CONNECTION CHARGE FEE 'IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT T ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEW R APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 1 OWNER OR NEW HOUSE SEWER OWNERS AGENT NECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP,PITtS) 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 1 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 CRIBED RESIDENTIAL PR ERTY. gBAN DON HOUSE SEWER J SIGNATURE APERMITTEE ' 0 BACKFILL SEPTIC TANKS ❑ SEEP,PIT(S) ❑ CESSPOOLS VALIDATION , CK. M.O. CASH L o9955a hUG 4 1 0 D 5:00 " 2i7o 76A � APPLICATION FOR PERMIT 76A 642D ' f COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL 'uI DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT OF BUILDING LOCALITY NEAREST APPLICANT TO FILL IN CROSS ST. (PRINT OR TYPE ONLY) LEGAL DE7 SCRIPTION LOT NO. OWNER MAIL SLOCK TRACT ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT / CITY 'TL�iufiL''E� TEL. N0. x'97 USE OF DISTRICT N0. GROUP CLASS MAP PROCESSED BY BUILDINGS >rf �t�- BK GONTRACTOR j��L�� .,j' �/G'�� ✓ 1 v p� ADDRESS j�: �'-�D q- - CONNECTION DATA CITY //�►,77..,--.zO`��'Ar TEL. NO. �' '1'�_- STATION ) 3 DEPTH STATE _ c LIC `_C/ _ MANHOLE REFERENCE / LOWER LICENSE NO. 1 ��CJ '1 J CLASS � NO. 1 DESCRIPTION OF WORK FEE TYPE OF CONNECTIO LENGTH OM / HOUSE SEWER CONNECTING TO �,/'] Y. CURB P.L. M.L.TO L. PUBLIC SEWER O �(! SEPTIC TANK.SEEPAGE PIT OR J� 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 $3.00 d CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIYtt EASEMENT RECORD.INSTR.NO. DATE O WORK TO HOUSE SEWER E� $3.00 V OVERFLOW SEEPAGE PIT,DRAINFIELD E XTN..CESSPOOL.DRYWELL.M AN HOLE $5.00 WIDENING OR ST. O ALTER.REPAIR OR ABANDON HOUSE HWY. 0 SEWER OR DISPOSAL SYSTEM $3.00 STATE ENCROACHMENT (J PERMIT NO. W CL INDUSTRIAL V) h WASTE APPROVAL Z - CHARGES OWNER'S PERMIT $ o0 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER. DATEIN 70 R'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER •( ` OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK.SEEP,PITS) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL Cl DRYWELL ❑ I HEREBY CE&T YT AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REOU1 Y LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA 0*'T I A LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RE51DE-IN, T BOVE RI RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER 51 GN QF PU T AT_a,E" .- % ��' . ,, BACKFILL SEPTIC TANKS El'I' SEEP.PITIS) ❑ CESSPOPLS ❑ VALIDATIOlky, JACK R. ALLEN CK. M.O. CASH U-PERVISING MECHANICAL ENGINEER L o .� 4 N FE$ IC