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Home My Public Portal About9426 LIVE OAK AVE_Sewer__ 7HA542D CEHOB 859 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FNEAREST G 77 JOHN A. LAMBIE, County Engineer CASSATT D. GRIFFIN, Supt of Building Y FOR APPLICANT TO FILL IN T. LEGAL _ DESCRIPTION LOT NO.%.-• 17 OWNER BLOCK TRACT MAIL ADDRESS NO.OF BLDGS. SIZE OF LOT NOW ON LOT CITY - TEL. NO. =�y"""�•fb•�� Ma USE BUILDINGS BK PG DISTRICT NO. GROUP MAP PROCESSED BY �..� CONTRACTOR - - ADDRESS r---t CONNECTION DATA CITY TEL.NO.- STATION _ �'- F r r1 DEPTH STATE MANHOLE REFERENCE UPPER REGISTRATION NO. / B COUNTY LOWER NO. DESCRIPTION OF WORK FEE » HOUSE SEWER CONNECTING TO 7 •� � �� "�� .. J PUBLIC SEWER @ $3.00 TYPE OF CONNECTION LENGjW FROM SEPTIC TANK,SEEPAGE PIT OR Y. CUR P.L. M. 70 P.L. PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.. CESSPOOL. DRYWELL @ $2.00 HOUSE SEWER CONNECTING TO r,:" P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. N0. JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. �� ROAD PERMIT NO. _ WORK TO HOUSE SEWER @ $1.00 s A,T a-REi-*tROR'ABANDON HOUSE STATE ENCROACHMENT SEWER OR-&KP"*L-'9'fS7E4A @ $1.00 ""� PERMIT NO. ; INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE f .'� %) REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OF 19- NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER.REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFI LL SEPTIC TANKS ❑ SIGNATURE SEEP.PIT(S) ❑ CESSPOOLS ❑ OF PERMITTEE Or VALIDATION ROBERT A. WOOD CK. Y.o. CASH SUPERVISING MECHANICAL ENGINEER DFPA_UTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL DIVISION OF BUILDING-AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES BUILDING WILLIAM J. FOX, COUNTY ENGINEER ; ADDRESS 7�/�G ^��{ 3z ,C/ PAI _< APPLICANT TO FILL I7;1DISTRICT LOCALITYBUILDING �y�� 2� �� NEAREST00ADDRESS ,o CROSS ST.LOCALITY NO. SERIAL NO. PERMIT NO. c NEAREST A S CROSS ST. ` RECEIVED BY Ready for Inspection DATE ISSU D OWNERf� MAIL �- /j� .i/ USE ZONE OCCUPANCY MAP ADDRESS UY'Y/Sr f/ �/i / BK PG CITY TEL.NO. ��(p/.f- _: dba f� `� CONTRACTO - /(/t� CO.IMP NO. E1 � s ADDRESS �. JOB N0 — . r 'CITY J .t TEL.NOL D U Alee.00I TRUNK PERMIT N0. REGISTRATION N0. /J D y ® STATE COUNTY ROAD PERMIT N0. LEGALi DESCRIPTION LOT NO. STATE ENCROACHMENT PERMIT NO. BLOCK TRACT INDUSTRIAL WASTE APPROVAL j SIZE OF LOT NO:OF S NOW ON LOTL CHARGES ,- USE OF BUILDINGSCONNECTION C E FEE _ NO. DESCRIP ION OF WORK FEE HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE__ PUBLICSEWER @ $ 3.50 RECEIPT NO. AT BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM I.00 CONNECT ADDITIONAL BLDO.OR EXCEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING NO. DATE BY ,SEWER OR DISPOSAL SYSTEM 1.00 -DISCONNECTIAND ABANDON SEWER _•- AND/OR-DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR e PITS'AND/OR DRAINFIELD 2.00 STATION L.`-7 DEPTH 6 CESSPOOL—DRYWELL SPECIAL CONDITIONS ONLY 2.00 pr 'W I'!/ 0� AN OLE REFERENCE L WE _ O TYPE IOFF CONNECTIO LENGTH FROM OWNERS PERMIT $ 00 Y. cuR6 jflP L. M.L.TO P.L. AUTHORIZATION I TOTAL FEE Q, •�� 1 HAVE.THIS DATE CONTRACTED WITH THE HEREIN NAMED -CONTRACTOR TO CONNECT THE ABOVE DE CRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE `'DWELLING TO THE PUBLIC SEWER JPROPERTY. SIGNED THIS.__.'4__2_._..DAY OF__�-_ �_ ._..19,6 NEWHOUSE SEWER OWNER OR. CONNECT ADDITIONAL OWNERS ENT __.____49#� ..__ __ ._.__. BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) ADDRESS ._ ._. __ ____fR._'___ �___._.SJ�. lf ..__. AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE RE13 APP I CESSPOOL DRYWELL CATION AND STATE THAT THE ABOVE,IS CORRND AGRETO COMPLY WITH ALL COUNTY ORDINANCES ATE LAWS ALTER, REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM IHEREBY CERTIFY THAT I AM PROPERGISTERED DISCONNECT PLUG AND AND/OR LICENSED AS REQUIRED BY LOS ANCOUNTY ABANDON HOUSE SEWER AND STATE OF CALIFORNIA OR THAT I AM TAL OWN-ER OF THE ABOVE DESCRIBED RESIDENTIALRTY. BACKFILL SEPTIC TANKS❑i1 SEEP.PIT(S)� CESSPOOLS SIGNATUREOF PERMITTEE--- -_ - -.._......... ..... ..... ....._......... 76A642A 663. 7/53