The URL can be used to link to this page

Home My Public Portal About5518-5518 1/2 MCCULLOCH AVE_Sewer__ oA6420APPLICATION. FOR PERMIT �8 E•688 3-S5 DIVISION OF BUILDING AND SAFETY SEWER--SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS OASSATT D.GRIFFIN,SUP'T OR BUILDING LOCALITY Tale City FOR APPLICANT TO FILL IN NEAREST DESCRIPTION LOT NO, OWNER BLOCK TRACT --- .%.��° }„s,d: ��d#,�+ MAIL ADDRESS_— same f N0. OF BL _ SIZE OP LOT_ i'b .!} € NOW ON LOT C(7Y TEL. NO. USE OF BUILDING' DISTRICT NO I GROUP MAP BK PG CONTRACTOR matin_ €r ADDRESS 323 X Santa Aulta _ _ � d CONNECTION DATA CITY Arcadia TEL. No-At 776>79 6>7' -�-- STATION v % ^'- - �`.-.DEPTH u5,t` D STATE MANHOLE REFERENCE " ✓° _ UPPER zz REGISTRATION.NO. 116i�d8'C,3 ❑ COUNTY ItO. DESCRIPTION OF WORK FEE --• - ---- — e -- - TYPE OF CONNEC , LENGTH -ROAM HOUSE SEWER CONNECTING TO ^�'� 'Pill' --- P.L. H L. TO P L._-_.�; __._..__PUBLIC SE,W R $ 3.50_ _ - - —- -- F HOUSE SEWER CONNECTING TO - —�—PRIVATE DISPOSAL SYSTEM 1 C0�� __-- -- --- ----- —.-_ .. A CONNECT ADDITIONAL BLDG. OR - P 0 N . WORK TO HOUSE SEVIER1.00. CO. IMP ..NO.._ !��'�.' I B NO. ALTER OR REPAIR EXISTING -- - - —_-T y SEWER OR DISPOSAL SYSTEM 1.00 TRUNK PERMIT NO. ROAD PERMIT NO.."'tl DISCONNECT AND ABANDON SEWERSTATESTATE NrROACHMENT ANWOR DISPOSAL YSTEM 1.00--J—_ R PE 'd T O - SEPTIC T\I`./., SE P CF PIT OR -- PET$AND/OR DRAINPIELD 2.00INDUJ TRIAL --� ---- — ---- —C WASTE APPROVAL .. { SSC>OOL-DRYWELL �---�.--.---�-� ` - -� SPECIAL CONDITIONS ONLY 2.00 CHARGES CONNECX'JO 'CHARGE FEE oa PERMIT S I —. ---- -- ---- O�NER�S _I �--.�- AUTHORIZATION TOTAL FEES � ��"tea REIMBURSEMENT FEE 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER '-- NEW HOUSE SEWER SIGNED THIS—.--.—DAY OF__—-- ___7I'---_ _ OWNER OR CONNECT ADDITIONAL y EUILDING OR WORK OWNERS AGENT' - -- -_.._..-e. ___ — -.------ -._ -- ---- - SEPTIC TANK,SEEP, PITS} ADDRESS _ __ _ _ANDi OR DRAIN_FIELD I HEREBY ACKNOWLEDGE THAT I HAVE. READ THIS APPLICATION CESSPOOL 0 DRYWELL.L�^ AND SLATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPA.tR„SEWER OR _ PLUMBING AND: SEWERS. SEWAGE DI Af RS S SYSTEMEOR _ I HEREBY" CERTIFY THAT I A}d PROPERLY REGISTERED AND/OR - ---�— LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE _A_BA_NDUN HOUSE SEWER DESCRIBED RESIDENTIAL PROPERTY, BACKFILL SEPTIC TANKS(. �� . SEEP. PIT(S) _CESSPOOLS T] SIGNATURE OF PERMITTEE_ F WILLIAM J.FOX, COUNTY ENGINEER VALIDATION R.A.WOOD, CHIEF PLBG. INSPECTOR _� `_. .E808 3 62 '6A6420 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS 1-JIA COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY NEAREST Q FOR APPLICANT TO FILL IN FCROSS 71T. LEGAL DESCRIPTION LOT NO. OWNER MAIL BLOCK TRACT k- Z, ADDRESS i NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY- TEL. NO. 41, S OF BUILDINGS DISTRICT NO. GROUP MAP PG PROCESSED BY SK CONTRACTOR ADDRESS 1,' 7t rL CONNECTION DAT C IT Y STATION DEPTH TEL� NO. STATE LIC MANHOLE RE"FCRENCEUPPER LICENSE N04 GLASS LOWER _i�_ -LENGTH FROM DES_ PTION OF WORK FEE TYPE OF CONNECTION _-T—HOUSE SEWER CONNECTING TO CURB P.L. M.L.TO P.L. PUBLIC IC SEWER @ $5-00 NQ, SEPTIC TANK,SEEPAGE PIT OR @ $10.00 P.NO, JOB NO:`-, 0 AND/OR DRAINFIELD C0.1m SE SEWER CONNECTING TO TRUNK PERMI ROAD PERMIT NO... '1 PRIVATE DISPOSAL SYSTEM $3.00 0 ONNECT ADDITIONAL BLDG OR r AFFI RECORD.INWM NO. DAT .......�WORK TO HOUSE SEWER S3.00yj OVERFLOW SEEPAGE PIT,GRAINFIELD CL EXTN..CESSPOOL,DRYWELL.MANHOLE @ $5.00 Lf) HWY,OR ST.WIDENING ALTER.REPAIR OR ABANDON HOUSE - z SEWER OR DISPOSAL SYSTEM 0 $3.00 STATE ENCROACHMENT PERMIT NO. z: INDUSTRIAL WASTE APPROVAL CHARGES OWNER'S PERMIT 2. 00 AUTHORIZATION[_TOTAL__FEE ,(- � , CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE T RACTORTo CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC USLI C SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP.PITS) IHEREBY ACKNOWLEDGE THAT I HAVE'READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE E ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS, CESSPOOL ❑ DRYW ELL ❑ I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICE _E NEED AS REQUIRED By THE ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM HE: LEGAL OWNER OF. AND INTEND TO RESIDE IN, THE ABOVE DESCRtB'ED RESIDENTIAL PROPERTY. -CONNECT PLUG AND ABANDON HOUSE SEWER SIGNATURE OF PERmrrTEE_ BACKFILL SEPTIC TANKS ❑ SEEP.PIT(S) [I CESSPOOLS VALIDATION JACK R. ALLEN SUPERVISING MECHANICAL ENGINEER CK. " M.0 CASH �EBOS 3 2 6A64201, APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS -b SOL=, ),-n; COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY NEAREST '" _J FOR APPLICANT TO FILL IN [CROSS ST. C4 LEGAL Z_ OWNER t-LI 't _DESCRIPTION LOT NO. L-i L. MAIL BLOCK TRACT C.,I r?. ADORESS-� 2,L c� V(St--L-1�2A� N F BLDGS. t,o.out, LOT OW0. LOT j tjtgl. NO, SIZE OF NO N CiTY',��iK' USE OF BUILDINGS DISTRICT N GROUP MAI PROCESSED 11Y BK PG CONTRACTOR L ADDRESS CONNECTION DATA CITY STEL. NO. 114 ol I STATION DEPTH STATE LIC UPPER LICENSE NOi CLASS MANHOLE REFERENCE LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM CURB P.L. M.L.TO P.L. OUSE SEWER CONNECTING TO Y. CL PUBLIC SEWER @ $5.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT 0 CO.IMP. NO. JOB NO. PITS AND/OR DRAINFIELD @ SjO.00— - HOUSE SEWER CONNECTING TO TRUNK PERMIT NO, ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ S3.00 WAIVER 0 �,,ST7 CONN€CT ADD TIONAL BLDG F- R NO DATE TO OUSE SEWER @ $3.00 u OVERFLOW SEEPAGE P-IT-*D-R A-IN FIE L 6 Lu _I EXTN :CESSPOOL ORYWELL MANHOLE @ S5.00 iL ALTER,REPA R OR ABANDON HOUSE HWY.OR ST.WIDENING SEWER OR.DISPOSAL SYSTEM @ $3.00 STATE ENCROACHMENT - z PERMIT NO. INDUSTRIAL WASTE APPROVAL 3 .z _CHARGES OWNERT--l-mai�ff' 21 00 j— CONNECTION CHARGE FEE AUTHORIZATION[TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN I NAMED CON. REIMBURSEMENT FEE TRACTOR T ECT THE ABOVE DESCRIBED EXISTING DWELLING 0 Co''4N To THE PUB L IC SEWER. APPROVALS DA E INSPEC 'S SIGNATURE SIGNED THIS—DAY OF-19— OWNER OR NEW HOUSE SEWER OWNERS AGENT--- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS— SEPTIC TANK.SEEP.PIT(S) IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATAON AND/OR DRAINFIELD A N D STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ------- WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING ING AND SEWERS. CESSPOOL 0 DRYWELL ❑ IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM ICALI FORNIA OR THAT T THE LEGAL OWNER (AF. AND INTEND TO DISCONNECT PLUG AND RESIDE IN. TH� .T A ESCRISED REStD7.,W-fPAL PROPERTY. ABANDON HOUSE SEWER SIGNAT PF BACKFILL..ITI-TANKS OF SEEP,PIT($) 0 CESSPOOLS 11 VALIDATION JACK R. ALLEN K. i I M.O. CASH SUPERVISING MECHANICAL ENGINEER 1411",i