HomeMy Public PortalAbout9441 LONGDEN AVE_Sewer__ DEPART of COUNTY ENGINEER SEWER=SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES •.I BUILDING � 'r
WILLIAM J. FOX, COUNTY ENGINEER q,,Zv /
ADDRESS
f �fI
FO APPLI A TP FILL IN LOCALITY
BUILDING NEAREST
ADDRESS GROSS ST. ,Q J
LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO'.
I
NEAREST AD b 47
CROSS ST.. _
RE'EIVED BY Ready for Inspection DATEISSU�EDD'
OWNER r /� I 1 S /J eq., p.--90�,`.."y"�
MAILUSE hiE OCCUPANCY SK G
ADDRESS I
CITY . M ftAM-NO.
CONTRACTOR fqf CO.IMP.NO. 77+�"��j
ADDRESS b�� - I JOB.N0.
CITY ` TEL.NO.r,4 TRUNK PERMIT NO.
ss STATE
REGISTRATION N0. 1174,0.1-7-41 ���C'�OGUNTY ROAD PERMIT N0.
A 7 40
DESCRIPTION LO .NO �f+ ° �R STATE ENCROACHMENT
LEGAL
PERMIT NO.
BLOCK TRACT INDUSTRIAL
WASTE APPROVAL
812E OF LOT 1✓ � a , NO.OF BLDGB. �„� CHARGES
NOW ON LOT
BUILUSE
DINGS ' (.�OU 6 iVAa CM CONNECTION CHARGE�EE
NO. DESCRIPTION OF W• K FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTI TO
PUBLIC SEWER @ $ 3.50 RECEIPT NO. I DATE !I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR CEP7�ON RECORDED
WORK TO HOUSE SEWER 1.00 . l
ALTER OR REPAIR EXISTING NOI t DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEEPAGE
P TSAND/OREPTIC TANK�DRAI FIIELDTOR 2.00 STATION $` �L 7/j DEPTH �� O
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 Q O MANHOLE REFERENCE
�, 7.• -- UPPER
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT # I 00 �`� CURB r L - M.L.TO P.L.
AUTHORIZATION TOTAL FEE 4
I .HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED ,
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING.- APPROVALS INSPECTOR'SSIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS...: DAY NEW HOUSE-SEWER ( //fj�,r` t .��. - 3 s y
OWNER OR 1 bNNECTADDITIONAL v
UILDING OR WORK
OWNERS AR
SEPTIC TANK,SEEP.PIT(S)
ADDRESS .. ... ._ AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI-' 'CESSPOOL[] DRYWELL I]
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREES
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED', DISCONNECT PLUG AND
AND LICEN8ED AS REQUIRED BY LOS ANGELES COUNTY , .ABANDON HOUSE.$EWER
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-;
ER OF THE ABOVE DE HIRED RESIDENTIA PROPERTY- BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)[3 CESSPOOLS MAtf:&#
OF PERMITTE .. ._ .�_.. ... _ _. �, Z -
7RAe42A Rss piss v ..'�...��� f�9� •f7.s,1. �FUL'
`_A642D
7Efi�20 APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGIIVEEII
SEWER-SEWAGE DISPOSAL
BUILDING AND SAFETY DIVISION BUILDING �p; g
JOAN A. LAMBIE, County Engineer ADDRESS - � � ��r �ITS/ - I WILLIAM A. JENSEN, Supt of Building f
LOCALITY ;
NEAREST .'
FOR L1 A1'S Ld�vAAtl TO TFILL INCRG55 ST
t
LEGAL—
DE.SCR(YT IIJN 1_OT NO __�,��. i ,r OWNER _._'�K'✓ _.d-, )
_ f MAI L�
BLOCK TRACT ADDRESS
D.O. OF BLDGS
SIZE .)I- LOT NOW ON LO7 CITY TEL. NO.
:USE Oz
BUILDIN DISTRICT NO. ROUP MAP PR_ FSSED BY
BK PG
ONTRACT OR I �+�,_L.,.., �. -�i 'F r• .' - __
ADD x.S CONNECTION DATA
F � _�
CITY : gry E"'._°TEL NO: Y J-roT:ATIOu .DEP"['ii
STATE "
£ MANHOLE REF''.P>-'.NC.c
'R£G1 TRA-.ION r..iO. COUNTY LOWER
No. DESK.RIPT�ON 0F VNCiRiC FEE 'TYPE OF CONN CTIDN - LENGTH FROM --^-"--
HO SE SEWER CONNECTING rO — Y. CURB P L M.L CO P.L. •
P,EBLIC NE4. L1a' -- __. -�_ - 6
YANK _EEPAGV.PIT OR $10.00 .I CO.IMP.NO. 10B NO _
PI SAP�D QRORAINFIELD -.--- @ _
I YO laE SEW CR COh NECTi N.. TO -___ ____- 'TRUNK PERMIT Ij7 ''.• � r .- _ ROAD PERMIT c20.
PRIVATE DISPOSAL SYSTEM @ 3$3.00 '.. "_. ,/ '.•'
CONNEc T AVOITIONAL BLDG.OR AF:P1DAV1[ wa.lYFw rEA.,FMENY i R€_ IRD INSTR. NOI DATE.._..--
WORK TO HOUSE SEWER Y,3.00
__-E_— _.___._
- I OVRFLOW_ SE E.PA.�E PIT,DAA NFIcLD
I
EJIl N.,CF_ SI'OO L.DRYWELL MANHOLE @ $5.00 I '
ALa Ei�,FEF�1R J¢^ABA:N HWY. OR ST.WIDENING
SEWER OFL .SIPOS A4.SYSTEM $3
@ .00
aQx ICHMENT
PERMIT NO-
INDUSTRIAL,
OINDUSTRIAL -
11
WASTE APPROVAL
I CHARGE'S
WNER'S PEWN-11 21 00
-__... CONNECTION CHARGE r'c.
AUTHORIZATION TOTAL FEE '" -_--- - --
HAVE AT THIS DATE. A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT_FE_,
T! CTC ,R T6 Cn VNEc_T THE ABOVE DESCRIBED EXiS-TING DWELLING
LC ------ - ---- ----- ------ ------- ----
10 �iF PUF _, ,h ER. APPROVALS DATE: �INSPECTOR'S SIC.NATURE
SIGNED THio-- S.7fi�Y t� ------------�4.-_ --... __.---- ---- -----�-- -------t----- -------------
O`NER OR
NEW HOUSE SEWER I
CONNECT ADDITIONAL
BUILDING OR WORK
ADD 5.
SEPTIC rANK,SEEP,PITS)
IHER.BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND!OR CSRAINFtELD
P:FiD STATE 'THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORDINANCES AND STATE: LAWS REGULATING
P_UMB ING AND SEWERS. CE5SPOOL [1 DRYWELL
1 HEREBY E:RTI FY THAT I AM PROPERLY REGISTERED AND/OR ALTER N PAIR'.^SEWER OR i;. �-- --- --
!CENSED AS REQUIR*D BY LOS .ANGLES COUNTY AND STAT. OF' SEWAGE DISPOSAL SYSTEM
AL'FORNI.A OR THAT i AIM 'THE VF6AL OCA`NER OF, AND INTEND TO
AU`viOIBERESIDENTAL DISCONNECT PLUG AND
RESIDE iNTh �— -�I e—_- T---- --_
ABANDON HOUSE SEWER
4 �
BA.CKF'Lf SEP1IC TANKS
OF PERhIi7TCE '�+� �§= SEEP.PITtS) �] CESSPOOLS
'' ')VALIDATION ROBERT A. WOOD
�,
,/GKM.O. CASH SUPERVISING MECHANICAL ENGINEER
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