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Home My Public Portal About9250 LOWER AZUSA RD_Sewer__ r8O8 5-65 ,6A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING :.S ---t JOHN A. LAMM[:. (.punt} H,ngr AD.11 E I-VI e— COI.KNIV, A. IFNKIN�),Sup"t. of Buil,ling, NEARS LOCAL TY ST FOR APPLICANT TO FILL IN CROSS ST DESCRIYi ON LOT N 4" OWNER MAIL BLOCK TRACT'4_�'l ADDRESS NO. OF SLOGS. SIZE OF._LOT NOW ON LOT CITY TEL. NO. USE O BUILDINGSDISTRICT NO, GROU PI MAP PROCESr BY ....... -,t7 BK PG CONTRACTOR C�— ADDRESSCONNECTION ST ION DEPTH CITY TEL. I. - LICENSE N SE UPPER NO. CLASS MANHO REFERENCE -1 LOWER LO F-R---- DESCRIPTfON OF W(DIRK-- -FEE_____- TYPED ONNECTION LENGTO"rROM --5E-W---F-R-CONNECT-tNQi Y. URB P.L. M.L.76 P.L. PUBLIC SEWER K,—SE-f A7P.C. 0. 0- PITS AN N -I-FN J NO. 0 AND CR ORA FIELD jo CO.CO�IMP.NO. HOUSE SEWER CONNFCTIN(3 TO j. TRUNK PERMIT NO. AD PERMIT NO, I PRIVATE DISPOSAL SYSTEM $ 3.G01 9x -6 CCDT�doiz— — WAIVER EASIM 0 fffT-c b N wt 6 f-Aob fYi crii4 L I A FFI 15A V I T ECORD.INSTR.NO. DATE WORK TO HOUSE SEWER $ 3.W R. REPFAI-ff u SEWER OR DISPOSAL SYSTEM $ 3-W LLI HWY.OR ST-WIDE G 0. PTNCESS PO ,-, MANIIW_E $ 5.001 — ---- - -- --- 0 ------ STATE ENCROA MENT z PERCOLATION TEST $ 5.0 c" PERMIT NO. INDUSTRIA WAST ----------- H ARG Es OWNER'S PERMIT s 2 00 c C AUTHORIZATION 'AL FEE ONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER, APPROVALS I SDP TE Sl GNED TH I S--DAY OF---I 9 INSPECTOR'S SIGNATURE OWNER OR NEW HOUSE SEWER 7 OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC!AN SEEP,PIT D� '� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION A R W�j NFIEL AND STATE THAT THE ABOVE IS CORRECT AND AGREE To COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. RS, CESSPOOL 0 DRYWELL C3 IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA A OR THAT IAM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AN RESIDE IN, THE ABOVE DESCRIBED RESI T". ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS OF PERMITTEE__- F rl CESSPOOLS ❑ VALIDATION M.O. CASH L 2 4 54 Jm 2 1 D 15.0 W 6A94z0 APPLICATION FOR PER CT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL � DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING� i,.) _ JOHN A. LAMBIE, County Engineer ADDRESSj � ". -- '-- WILLIAM A. IENSE%d, mup't. o[ Building � ✓y LOCA L.T J. �. �.-••.�`. -, NEAREST FOR APPLI ANT TO FILL IN CROSS S' - LEGAL —._.. .._.. _... 1✓ __—. __ _._._... _ 9.__. -�rt�e _ 0E5CRIPT ON_ - LOT NO F OWNER MAIL •7 f ` —.- - BLOCK- TRACT �/.' .. ADDRESS NO. O BS. LD f"" S:ZE 0.8 LO'i NOW ON LOT CITY � r 'FEL. N .�-. USE OI" BUILDINGS DI,.T R.CT N GR OU PRC E BY - Bt< FG s ,yf �"F.1` L,4( � P MAP � rC D CONTRACTO.FW6ro , w � o °a.�. ,.....—....�._ .., -- L✓'�:. _ .._— _ _ - �_4_ ..,6 Sr CCC✓✓✓ ADDRESS CONNECTION DATA-------- - -- - —� - —— CATY TEL NO. STAT!0N DEPTH TATE MANHOLE REFERENCE �j ry ER REG IS t>TION NO OUNTY LOWER NO. DESCRIPTION OF WORK FEC TYPE OF 6QN14 ECTION LENGTH Af`FOM —_. - ___ __ ,r �HOUSF_SEWER CONN CCT7NG TO Y CUR@, P L M.L f3 P.L -Y P Bt IC SEWER @ $5.00 _ P C SI EPIC NK,SEEEA EPIT OR I �. NO _�• PI A14 /OR DRAINFIELD @ $10.00 CO IMP NO. &� _ li FiOt _'SE4dER CONNECTING TE? TRUNK PERMIT'NO CAD PERMITNO. _ PR ATF O AL SYSTEM @ S'i.OU _ __� W ONNFCT A D ION.AL.BLDG JP. _--- -- A FIDAdiT wMV R'CASEM Ek ECO INSTR. NO. DATE _ YORE(TC HOUSE SEWER @ $3.00 ___ OVEhK'L4?W S F .AGE P 7,ORAINFIELU rt EXTN CE 59Pb OLH ,DR KELL.MANOLE @ $5.00 . UING - ty) ALTER.REPAIR OR AB1N70N HOSE- —T— - HWY.OR ST'.WIDENs S W.>r;R OR DISPOSAL SYSTEM @ $3.00 E E STATNCROACHM E7V �— _y. PERMIT NO . INDUSTRIAL. . 1NDU STRIAt. IO MO'jr�n _PER.M_IT $ 2, WASTE APPROVAL, CHARGES —--. — CJD _— ,—_ AUTHORIZATION TOTALFEE CGNNECT!oly to ARGEFEE------ -�-- i HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEM�gE/N�TyF)EE �i TRACTOR T CONNECT THE. ABOVE DESCRIBED EXISTING DWELLING APPROVALS ._.__—_.._...__.- TD THE PUBLIC SEWER, I DATE INSPECTOR'S SiGNAY'URE SIGNED THIS—_ DAY OF ,_ 99_ -----__`_---_– OWN.ER OR NE:' HOUSE SEWER OWNERS.AG.EN7. -- - CONNECT ADDITIONAL BUi LDIN.G OR WORK aDDRE55 TANK, E _ _ _ _ _____ ____ —_ - SEPTIC ANh,K,SEEP F`.T(S) i He.REBY A'LKNOWLEDGE THAT I HAVE READ THIS APP41CATION AND/OR DRAINFIELD - AND STATE THAT THE ABOVE i5 CORRECT AND AGREE 'T'O COM PL!' _.--.— ._-.___--_. ___?• - �_::_¢_�._ _ —_ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING. I PL MEING. .AND SEWERS. CESSPOOL [J DRYW ELL I HEREB`-' 'FY THAT AM PROPERLY REGISTERED AND;OR ALTER,REPAIR,SEWER OR Ll CENSED AS REQUiRED Jby LOS ANGLES COUNTY AND STATE OF S.VdAGE DISPOSAL SYSTEM CA.L.IFU RNIA OR THAT f /AM THE "GAL e OWNER OF6XND INTEND TO D13CO N IN ECT PLUGAND RESIDE IN, THE ABO ' DES R EO RPSIDE- TIAL F aPERTY. ,. � ABANDON HOUSE SEWER SIGNATURE OF PF.RY!1TTF_,. _y �, _ �?+ '� �� _- EPILT SEP C'I TANTANKSu SE , SEEP.PIT l51 ❑ CESSPOOLS Qi VALIDATION ROBERT A. WOOD CK, M.O. CASH SUPERVi.S(NG MECHANICAL ENGINEER