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Home My Public Portal About6102 OAK AVE_Sewer__ AS42O6` 6APPLICATI FOR PER IT S 2.g42D - 1 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPO AL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION rNEAREST UILDING JOHN A. LAMBIE, COUNTY ENGINEER DDRESS rG" _ COLEMAN W. JENKINS, SUPT. OF BUILDING / LOCALITY (. , FOR APPLICANT TO FILL IN Rss LEGAL -- DESCRIPTION LOT NO. . bA _BLOCK _ TRACT & 9a+'V ✓ DRESS Sc' NO. OF BLDb_ SIZE OF LOT NOW ON LOT 0 r CIT -- �✓"- NO. USE OF BUILDINGS DISTRICT NO. GROUP MAP I PROCESSED BY _ BK PG COH7RACTOR. T ADDRESS ,y �' CONNECTION DATA F L.d'L— - CI - TEL. STATION DEPTH STATE NO,;. -"� '"`y ^7 L. yam~' LIC MANHOLE REFERENCE J '� `�7,.� y _ _ ___ �. L 3 �?�.! J CLA55 /4 _ - ER NO. .DESCRIPTION O FEE TYPE OF CONNECTION L NGTH F OM HOUSE SEWER CONNECTING TO - Y. CURB P.L. M.L.TO P.L. D,. _j PUBLIC _ $5.00 //yy SEWER I P.C.NO.. 0 iSEPTIC TANK,SEEPAGE PIT OR JOB NO. PITS AND/OR DRAINFIELD E10:00� CO.IMP_NO. u HOUSE SEWER CONNECTING TO� y TRUNK PERMIT NO. ROAD PERMIT NO- PRIVATE DISPOSAL SYSTEM $3.00 GON NECT ADDITIONAL BLDG , ---� y AFFIDAVIT WAIVER fiASE MENT RECORD.INSTR.NO. DATE Imo" I ATO HOUSE SEWER @ $3.00 1 Lu -OVERFLOW SEF_PAGE PIT.DRAINFIELD EXTN..CESSPOOL.DRYWELL,MANHOLE Q $5_00 HW Y.OR ST.WIDENING •may � ALTER.REPAIR OR ABANDON HOUSE I - SEWER OR DISPOSAL SYSTEM _I @ $3-00 _ STATE ENCROACHMENT ._ I--- PERMIT NO- INDUSTRIAL O --i----_- -_-�--- -_ WASTE APPROVAL 3 -a. CHARG OWNERS P_E_R_MIT s' oot" C-O-N—NEC—TIO—N-CA G- E FEE AV1HORTZATION TOTAL FEE ia5-I J - I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIM$URSEM.ENT FEE TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -------- -IQ THE PUBLIC SEWER. APPROVALS DATE 1 NSPECTOR'S SIGNATURE SIGNED THIS D OF ----- OWNER OR NEW HOUSE SEWER OWNERS AGENT_. CONNECT ADDITIONAL ADDRESS.-_ BUILDING OR WORK f{� >✓--f.,f y ;v:'� v`I•Y;-.��d...> -__�- SEPTIC TANK;SEEP,PITS) I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE. THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS: CESSPOOL ❑ 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 S YSTEM =LICALIFOR OR THAT 1 AM 7t LEGAL OWNER OF ANDkE�N;TO DISCONNECT PLUG AND .F 7 THE'. OVE DE .2LE RESIDENTI OPE ABANDON HOUSE SEWER SIG BACKFILLSEPTIC TANKS ❑ F PER �,✓��(+�(„� 7✓ -' EP,PIT(S) ❑ CESSPwig OOLS ❑ mmomo VAL DATIO JACK R. ALLEN CK_ M.O. CASSUPERVISING MECHANICAL ENGINEER - 5.00- -¢8°8Iib APPLICATIONS FOR PER T 76A 6Aec , J COUNTY OF LOS ANGELES SEWER--SEWAGE ISP®SAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ' JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS _ COLEMAN W. JENKINS, SUPT. OF BUILDING — LOCALITY NEAREST FOR APPLICANT TO FILL IN �Rg85 ST. LEGAL DESCRIPTION LOT NO. OWNER MAIL BLOCK TRACT S .r�i JsAS}+C l X lie NBLTS. S�C(,X SIZE OF LOT YNOW ON LOT CITY TEL. NO. USE OF BUILDINGS DISTRICT N . 6R MAP PROSE BY .+ E�BK PG CONTRACTOR ``� l/ "'"' �! �"K, .! ,✓ t- "'��Ill... ADDRESS) Li CONNECTION.DATA STATION DEPTHCITY �y STATE LIC MANHOLE REFERENCE / LICENSE NO: CLASS LOWER NO, DESCRIPTION OF WORK FEE TYPE OF CONNECTION L. TH�ROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO L. PUBLIC SEWER SEPTIC TANK,SEEPAGE PIT OR P.C.NO. PITS ANO/OR DRAINFIELD @ $10.00 CO.IMP. NO- JOB NO. HOUSE SEWER CDNNECTfNG TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 C:) ONNECT ADDITIONAL BLDG. OR AFFIDAVIT WAIYEE EASEMENT RECORD:INSTR.NO. DATE U I W RKTO HOUSE SEWER $3.00--I}-- ERFLOW SEEPAGE PIT.-DRAINFIELD _,�__ _ (� EXTN..CESSPOOL.D ANHOLE @ $5.00 F- ALTER.REPAiR O"ABANDO OUSE - HWY.OR ST.WIDENING Lu SEWER M $3_00 _ STATEENCROACHM£NT � v - a_ PERMIT NO. Oil �... �--- --------- INDUSTRIAL 1 WASTE APPROVAL if CHARGES OWNER'S PERMIT ---- S 2121—Oo ----- -- — — --- — CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE - -� --. I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO..CONNECT THE ABOVE.DESCRI ED EEXISTING. DWELLING --- -- -------- TO THE PUBLIC S E APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF I 1 ----�-- —'" OWNER OR NEW HOUSE SEWER OWNERS CONNECT ADDITIONAL ` ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP,PIT(S) HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ❑ PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR ,1 LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM Y CALIFORNIA OR.THAT I A E LEGAL OWNER OF, AND INTEND TO --'-- —� RESIDE IN, THE A RIBED S.IDENTIAL PROPERTY. DISCONNECT PLUG AND `' l% `r I/y ABANDON HOUSE SEWER F —J SIGNATURE BACKFILL SEPTIC TANKS ❑ OF PERMITTEE — -- SEEP.PIT(S) ❑, CESSPOOLS ❑ VALIDA'T'ION JACK R. ALLEN j:*. M.q. CASH SUPERVISING MECHANICAL ENGINEER -E808 9 Q-53 6A64.2D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DI§fOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING E JOHN A. LAMBIE, County Engineer ADDRESS WILLIAM A. JENSEN, Sup'! of Building � LOCALITY NEAREST ..._.. r-ROSS T FOR APPLICANT TO FILL IN - - DESCRIPTION LOT NO 1" ! ONNh - .. MAIL ,6� �sr9T BLOCK TRACT ADDR F_SS NO. OF BI_DGS. eF`�r yrs•�>• S "'� SIZE OF LOT NOW ON LOT CITTEL. NO. .d- 'S ✓�" '''�. USE OF ,APROCESSED BY 15TRIC'f NO. GROUP MAP BUILDINGS ^"� BK PG F. CONTRA CTO ;_ � �/`` ..� �� :� •: r• _ ..ADORESS� ,�" " r ;.,c^,�' � ., -.'-' CONNECTION DATA STATION DEPTH C11 Y '". f•,_7"x.>T TEL. NO TATE MANHOLE REFERENCE REGISTRATIO!J NO ,�f ,{" COUNTY i r r `LOWER -Z DESCRIPTION - NO. DESCRIPTION OF WDRK FEE TYPE OF CONNECTION LENGTH FROM ---- HOU5E S(=W Eft CONNECTING , 'T" Y'____ _ CURB _ P_L`_ - WL.TO P,L-;: PUBLIC SEWER @ $5.00 -=Y&�-" '~- ._ P.C.NO. C- 5 PT!C TANK SEEPA PIT _CO.IMP, NO. JOB NO. C PI"'S ANO/OR DR:AINFIELO @ $10.00 --- --,-- - --- -------- - HOUSE SEWER CONNECTING TO --- - TRUNK PERMIT NO ROAD PERMIT NO, - PRIVATS DISPOSAL SYSTEM $3.00 .. CONNECT ADDITIONAL BLDG OR AFFIDAVIT WAIVER CASE#ENT T RECORD. INSTR NO. DATE r WORK TO HOUSE SEWER $3.00-4 ! I --TOY ERr`LOW 5_Ep.A F Pt7 DR0.1Nt-IELD XTNCE D SPOOL, RYW LL,MANHOLE 55.00 •_ ,._. HWY. OR ST.WIDENING ALTER',RE f.AIR OR ABANDON HOUSE: SEWER OR DISPOSAL SYSTEM Cad $3.00 --.—uR--_._--_..._.—_ !_—_-�-� STATE ENCOACHMENT _.., PERMIT NO. _—} L--- INDUSTRIAL WASTE APPROVAL _-__.•__--.__.--_-�--- -- T CHARGES OWNEPERMIT _ z, oo AUTHORIZATION TOTAL FEE '---- '. CONNECTION CHARGE rEE --- --� — 'I HAVE AT THIS DATE .A CONTRACT WITH THE HEREIN NAMED CON- RE I M SU RSF_MpENT FEE c TRACTOR TO CONNEPT THE ABOVE OeSGRI D XI KING OWELLIN - _APPROVALS TO THE PUB'..! SE i DATE INSPECTORS SIGNATURE. { SIGNED THIS DAYe'f,.-1 S ------- --- OWNER OR k(� _NEW HOUSE SEWER OWNERS AGENT. -- CONNECT ADDITIONAL ! BUILDING OR WORK ADDRESS -`-- ----- -'- --- SEPTIC TANK,SEEP.PIT(s) ! I HFREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND'OR DRAINFIELD AND STATE 'THAT THE: ABOVE IS CORRECT AND AGREE TO COMPLY -----------'-------1--------- WITHALL, COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL. ❑ DRYW.ELL ❑ HEREBY CERT vY THA I AM PROPERLY REGISTERED AND/OR ALTER REPAIR,SEWER OR T_ EN5ED A.S FPEOUIRED- rY LA" ANGLES COUNTY AND,-rSTAT'E OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT�I,+r THE 'EGAL OWNER.OF AN �9NTENU TO RESIDE IN, 7riE Ae�CM.,`DESCI, D RE DENTIAi„ PR 'PTY. D�SCONNEc.T-PLUG AND ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TA _3r � ®". fes` NKS ❑ OF PERMITTEE __. - SEEP.PITS) ❑ CESSPOOLS VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH E