HomeMy Public PortalAbout9180 LONGDEN AVE_Sewer__ A P�1�!.L I C AT 10 ISI.. .FOR PERMIT
L�DIVII ' BYFIIIV3 SAFETY SEWER—SEWAGE DISPOSAL
Department of County Engineer
•� County of Los Angeles BUILDING ;C a
JOHN A. LAMB.IE, COUNTY ENGINEER _-ADDRESS_.._-. - ----
C:ASSATT D, GRIFFIN, SUPT of BuiLDMNG
LOCAL[T'Y
NEAREST j' - +Y
FOR APPLICANT TO FILA. IN--� --- cRoss sr, ;_ . _t
-LEGAL ..J
DESCRIPTION- LOT\Nb _ �~ OWNER
./:�-^ � - - ----- - MAIL I -
BLOCK TRACT 'p^� ,y'" - ADDRESS •,�..
N0. OF BLD ''
SIZE OF LOT _ N_OW ON LOT _ CITY .�, ..o,_�,.. TEL. NO..USE OF --- '--i -
BUILDINGS —o c- + T` - DISTRICT NO, GROUP MAP
-- �-- BK PG
CONTRACTOR -
v
ADDRFss - CONNECTION DATA
e°. - - -- ---- -
--- ---- ----
'� IOfiI L_ .,.�",L.. ' -aC ..8'PTHA.
CITY [ '; TA. TEL. NO, - ..-_ -
- �=--pyp''' MANH LE REFERENCE v r _ UPPER.
STATE
REGISTRATION N0. '� ' L] COUNTY
NO. DESCRIPTION OF WORK FEE .—
HOUSE SEWER CONNECTING TOI - TYPE OF CONNECTION LENGTH FROM
X -- -CURB- r,t, M,L. TO Y.L.
I PUBLIC SEWER _ @_$3.50
I SEPTIC TANK SEEPAGE PIT OR I
-_-.� PITS AND/OR DRAI_NFIELD.-- ---tur $3.00 _ _ _ -- -.--- -" - ----. -
OVERFLOW SEEPAGE PIT, DRAINFIELD - P. C. N0.
EXTN.,CESSPOOL.DRYWELL.MAN HOLE {a? .$2.01) _CO.-IMP, NO,iI i uY:,'` JOB NO.
HOUSE SEWER CONNECTING TO
_ �_PRI_VA7E_DISPOSAL SYSTEM _ +2a;_$_1.0_0 I _. TRUNK PERMIT NO _ _ ROAD PERMIT NO. -/� .._.
i
CONNECT ADD!T10NAL BLDG.OR STATE ENCROACHMENT - -
WORK 70 HOUSE SEWER----_^.__ i.00 _ _PE_RMIT N0.
1 ALTER,REPAIR OR ABANDON HOUSEINDUSTRIAL OVAL
— I �-
SEWER OR DISPOSAL SYSTEM (rx $1.00
—� ----- --- — —--------- wns "p ;
CONP'. l:1,N CHARGE FE.c - 1
OWNER'S PERMIT _ $ t 00 '`_—:- . --- --- ----------- — -- ---
AUTHORIZATION TOTAL FEE -lrf C APPROVALS ECTOR SSIGNATURF INSP
I DATE REIMBURSEMENT FLwT�+
`-
I HAVE A7 THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- ____._�_ --- �
TRACTOR 'TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER. �". _ NEW HOUSE SEWER
SIGNER THIS DAf OF
CONNECT ADDITIONAL
OWNER OR BUILDING OR WORK
—_ �—
OWNERS AGENT .a•�' .- -Y ------ --- "-
"' -T SEPTIC TANK,SEEP,PITS)
ADDRESS— _—-_ AND/-OR DRAINF'IELD_.....
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CEESSPOOLO DRYWEL.L O
AND STATE ,HAT.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
I HEREBY CERTIFY THAT I AM PROPERLY GISTERED ANDiOR DISCONNECT PLUG AND — —
LICENSED AS REQUIRED BY LOS ANGELS C NTY AND STATE OF ABANDON HOUSE SEWER -_ �
CALIFORNIA OR THAT 1 -AM THE LEGAL NER OF THE ABOVE ---- -- -- _ ---� _.
DESCRIBED REG,DENT[ PROPERLY -,/ BACKFILL SEPTIC TANKS
SIGNATURE SEEP. PIT(S) {L; CESSPOOLS r,,OF PERMITTEE c. J 's _ ".'doh'-.- lap
-- .ry-- F--_�.._.----
� .�� ��
IOHN A. LAMBIE,Coup'f'i ENGINEER V IDATICrN ROBERT A.WOOD,CHIEF PL,EIG,INSPEC OR
CAa
jj 5
1.�
16A64 APPLICATION FOR PERMIT 1
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
DePestment of County Engineer
County of Los Angeles BUILDING ✓, $�
JOHN A. LAM6tE, COUNTY EtvGttvADDRESS_ -- -
�J CASSATT D. GftIFF{^!, Su F'7 131"s3utt;pitC 1 = !> RLOCALITY
_ FOR APPLICANT T �' �I �, `:'� r R SS S .LEGAL
x
DES CRIP7dON LOT NO, "c":" l ��,.6�% OWNER
:i ,,v: MAIL
BLgCKTP,AC ADDRESS-8,._,,e
---- ----� "� - OFLI-�JG/S CITY TEL.N O.
SIZE OF.LOT _„/ ., NOW ONBLOT G '�USE OF
BUdLD6NG5 ,��::�a.' ..�y' _ �},� DISTRICT NO. GROUP j MAP
--- - - - — -- l
BK PG
-
CONTRACTOR 5-
ADDRESS )ANHOLE
CONNECTIONCITY �!' TEL, N0, REFERENCE s�ry�-y --- - -_-- PPER
_REGISTRATION [e'4, STATE
_N- - ❑ COUNTY -- ----__ �__
NO. DESCRIPTIOF WORK_ FEE -` ' ' ' '"�---- ----
---_.-.... TYPE OF CONNECTION LENGTH FROM +� ,�r
HOUSE SEWER CONNECTING TO Y. CURB P.L. M L. TO P.L. 12 e
PUBLIC SEWER _ Cn.2_ $3.5.0 I -- ---._-._...___--,..__
SEPTIC TANK SEEPAGE PIT OR -t
PITS AND/OR DRAINFIELD $3_00
_ fig;
_
OVERFLOW SEEPAGE PIT,DRAINFIELDts; P C N0.
i rXTN.,CESSPOOL,DRYWELL,MANHOLE (Qi) $2:00 .CO_I MP. NO.120 j --10B NO..---'-- ---
HOUSE SEWER CONNECTING TO
_{ PRIVATE DISPOSAL SYSTEM (d. $i.00 TRUNK PERMIT N0. - - ROAD PERMIT N0.
74
CONNECT ADDITIONAL BLDG.OR. STATE ENCROACHMENT
i
WORK TO HOUSE SEWER 04 $1.00 _ PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE J
SEWER OR DISPOSAL SYSTEM Cry' $f.00 INDUSTRIAL
WASTE APPROYA -
_..l --- ------ ---- ----- ---
"
NER°S PERMIT -- -�_.
^ �4
AUTHORIZATIONTOTAL ,FEE - — .REIMBURSEMENT FEE
I HAVE AT THIS. DATE A CONTRACTWITH THE HEREIN NAMED CON. APPROVALS DATE IINSPECT OR'SSIGN ATURF
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
10 THE PUBLIC SEWER `'. - an, NEW HOUSE SEWER
SIGNED THIS DAY QF_�?3i"�' 19� CONNECT ADDITIONAL I
OWNER OR N °' `` BUILDING OR WORK
OWNERS AGENT .r ----------..__ _..--- _----
SEPTIC TANK,SEEP,PITS)
ADURiSS AND/OR DRAINFIE'D
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOLL] DRYWELL❑
AND STAT£ 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
I HEREBY CERTIFY THAT I AM PROPERLY REGIS RED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANG£'ER.
�CW
OUN AND STAT£ OF ABANDON CT PLUGHOUSE AND
., L,LOF THCALIFORNIA OR THAT 1, AM THt LEGADESCRIBED RESIDENTII PROPERTY BACKFILL SEPTIC TANKSSIGNATUR£ POOLSQSEEP.PITS) ❑ CESS OF PERMITT
IOHN A. LAMBIE.Cou ' Y ENGINEER IDMION ROBERT A.WOOD, CHIEF PLEIG. (INSPECTOR
CH. M.
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