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Home My Public Portal About9240 LONGDEN AVE_Sewer__ -4 c08 2/70 �15A 642.0 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPO DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY 6;il-po' i I I EAR�ST- FOR APPLICANT TO FILL IN R.Sr (PRINT OR TYPE ONLY) sST_ LIfGAL -- John Larsha, :LS C-R 11P T 11)N FOR LOT N-0. OWNER �L.C. J MAIL 't jn4t TRACT -a�-t Las r- o .�l A..R... 1-1 NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE CTP BUILD INGS DISTRICT NO. GROUPCLAIS I MAP IFI?111511 By 1 CONTRACTOR 0,well �"3ros. plYLm�b' 6 CA- ADDRESS CONNECTION DATA STATION DEPTH CITY n'e, "'173 T .L. NO. STATE LIC MANHOLE REFERENCE UPPER LICENSE NO. CLASS NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH ROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO. L PUBLIC SEWER @_$5.00 -- P.C.NO. 5 EP T Fl-TANK,SEEPAGE PIT OR JOB NO. 1;5 AND/OR DRAINFIELD @ sl0.00 Co.IMP.NO. HOUSE SEWER CONNFC'CING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRWATE DISPOSAL SYSTEM @ $3.00 ADDITIONAL BLDG.OR AFlaAWT]- ;VAjVfiR' EASEMENT i RECORO. !NSTR.IN DATE 0 WORK T HOUSE SEWER 0 $3.00 OVERFLOW SEEPAGE PIT DRAINFIELD_ ____ ____ __ EXTN.,CESSPOOL.DRYWEL.L.MANHOL,E:0 $5.00 HWY.OR ST.WIDENING 0 ALTER,REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ S�1.00 STATE ENCROACHMENT fi PERMIT NO. INDUSTRIAL WASTE APPROVI z f OWNER'S PERMIT $1 00 CHARGES i CONNECTION CHARGE FEE r) AUTHORIZATIONI TOTAL FEE _ I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMWURSEM�NT FEE R � TATOR T NECT THE ABOVE DESCRIBED LXIST",NG DWELLING CO`4 IC S TO THE P0 USL EWER, APPROVALS D TIE SPE. OR'S SIC pNATURE SIGNED THIS—-DAY OF�--19-- OWNER OR NEW HOUSE SEWER OWNERS AGENT---------- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS HEREBY SEPTIC TANK.SEEP,PIT(S) I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE: IS CORRECT AND AGREE TO COMPLY WtTfj ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL 0 ORYWFLL ❑ IHERERY CERTIFY THAT I AM PROPERLY REGISTERED, AND/UR 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 --,,-S,&-, PLUG AN D I RESIDE IN, THE aV Ll:'illBEO RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER oUSESEWER SIGNATURE BACKFILLSEPTiCTANKS OF PERMITTEE SEEP.PITS) 5) D CESSPOOLS 10E] VALIDATION JACK R. ALLEN CK, 'I M.O. CASH SUPERVISING MECHANICAL ENGINEER Ll '5A°65420 APPLICATION FOR PERMI COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING:AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT, OF BUILDING LOCALITY TDle u I NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO, OWNER l o .aI ',:a <"nflY" --, '" BLOCK TRACT ?^ - i r \ MAIL T7 _I L +,S l i,',`1(„1 ADDRESS j.�,A� Bra NO. OF SLOGS, SIZE OF LOTS NOW ON LOT _I CITY �i C� -j =Z TEL, NO. y� ,,,, �f!' USE OF BUILDINGS xj I �% �i -.-- - DISTRICT NO. GROUPFr_7 MAP PROCESSED BY K PG CONTRACTOR e) ADDRESSI I,1 r ...17-"7 - T1-y'` CONNECTION ATA, CITY ry`�n Gal-!:P t >^ T � STATION DEPTH San `.a`L+ _•.C. '.I. TEL. NO. iC �'��:�'� sir TATE PPER $CKNSE NCS G LIC r. MANHOLE REFERENCE- - U, , _ t� _� CLASS 3_�_. _ NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION L€NGT FROM HOUSES EWER CONNECT]NG TO Y. CURB P.4. M.L.T P.L. _ PGBLIG SEWER $5..00 ----- SEPTEC TANK.SEEPAGE PVT OR - P.C.NO.. I PITS AND/OR DRAINFIELO $10.00 CO.IMP.NO. JOB.NO. HOUSE-SEWER CONNECTING TO j TRUNK PERMIT N.O. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3,00 i. ONNECT ADDITIONAL BLDG OR AFFIDAVIT WAfY[B I E MENT RECORD.1NSTR.NO. DATE C.J WORK TO HOUSE SEWER @ S_ .00 OVERFLOW SEEPAGE PIT DRAINFIELD +EXTN..CESSPOOL.DRYWELL.MANHOLE 6 $5.00 i -- -I - ABAN DON HOUSE � ,r^vl, HWY.OR ST.WIDENING I SEWER SYSTEM ------ �_ -____—__- W $3.00 �- STATE ENC ROACHMENT Q. I PERMIT NO. - ----`- ---'" ? -- INDUSTRIAL —E—� WASTE APPROVAL Ty OBR'S PERMIT .-_. T$+ +Q- u CHARGES WN AUTHORIZATION TOTAL FEF. -I- � CONNECTION CHARGE FEE --' 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO-CONNECT THE ABOVE DESCRIBED EXISTING DWELLING ---TO THE PUBLIC SrXR# _ ,��. y '" APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS l' '°DAY OF , ,l�' 1: ------ — — -�- - - -- - OWNER OR Hk) ✓ �a ✓ W: p NEW OSE SEWER OWNERS AGENT CO SECT ADDITIONAL AD ,3 DRESb J P` f}'=J - 3 L GOR WORK , - -- --_ S P 'TANK,SEEP,'PIT($) I HERI'SY ACKNOWLEDGE THAT 1 4'=t AVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT ANAGREE TOCOMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING �_.._. — _--------_- PLUMBING AND SEWERS. CESSPOOL ❑ ORYWELL 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY-'LOS ANGLES COUNTYTY AND STARE OF SF_WAGE DISPOSAL SYSTEM CALIFORNA1.1�7HE LEGAL OWNER OF, AND 1NTND�',0 ,DISCONNECT PLUG AND J � ,b ESCRIBED RESIDE AL PROPE;J2T+.' RESIDE IN, THE ABOVE ,- �' 'ABANDON HOUSE SEWER IA OR THAT 1 _ SIGNATURE F,"+y�✓ �,yfOF PERMTTTE _ff; _ ��1.�: ' E, ' BACKFILL SEPTIC TANKS. ❑ SEEP,PIT 5) ❑ CESSPOOLS ❑ VALIDATION JACK R. ALLEN M.0. CASH SUPERVISING MECHANICAL ENGINEER r