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Home My Public Portal About6536 OAK AVE_Sewer__ 16A 642C - CE308 - 9i73 APPLICATION FOR PERMIT _ COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FODRESS _ FOR APPLICANT TO FILL IN . LEGA DESCRI TION LOT NO."I ' — OWNER ._ gy'- �',r�7� lz MAIL BLOCK TRACT � '.. !` ADDRESS NO. OF SLOGS, SLZE OF LOT,."}�J +. __5J�)V6NOW ON LOT t CITY TEL. Ng, 15/4/119 USE OF a BUILDINGS '�'y-4"' DISTRICT NO. GROUP MAP PRgCESSED BY SK P3 CONTRACTOR .:.�_ 7j- ccr ey.r!':A t'' 'd-_ :b�' a t!� ✓ � ADDRESS �� ..9,°,_, ,.-- �'4 4-,%'� CONNECTION DATA qy 3 STATION DEPTH ' CITY �I'/.�,j- J=+�Z`1x' / TEL. NO. c >� ,1' ;,} ... gy aZ f+� MANHOLE REFERENCE UPPER STATE 9f' LIC ,r^�.£„ y^� _,. LICENSE NO: d CLASS C 7 LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y- CURB P.L. M.L.TO P.L. PUBLIC SEWER $7.00 ._ P.C.NO. SEPTIC TANK,SEEPAGE PIT OR JOB NO. PITS AND/OR DRAINFIELD $10.00 CO.IMP,Np. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM @ $3.00 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT wAev[[ [As[N[NT RECORD.iNSTR.NO. DATE WORK TO HOUSE SEWER $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL.DRYWELL, $S.00 ALTER, E HWY.OR ST.WIDENING *E W E R $3.00 <s'' -- -- � ._. _ STATEENCROACH MENT F� MANHOLE $7 00 PERMIT NO. _ _ PJ — — INDUSTRIAL Li.i WASTE APPROVAL � CHARGES OWNER'S PERMIT a 00 -- CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE "�->��:� - - - I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS TO THE PUBLIC SEWER. DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF-19— OWNER F 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT --- CONNECT ADDITIONAL ADDRESS__ BUILDING OR WORK SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT 3 HAVE READ THIS APPLICATION AND/OR O R DRAINFIELD AND STATE THAT THE ABOVE I5 CORRECT AND AGREE TO COMPLY —.-- WITH ALL COU NTV _ -'7�/0 STATE LAWS REGULATING I� PLO GING AN_O SL G�ERS:�"" CESSPOOL ❑ DRYWELL L„I „'`.,T I F L6"N'AE ES2TIFY THAT PROPERLY REGISTERED AND/O.R ALTER,R:,GA41R,SEWER OR R'itEQUIRE Y bS ANGLE z C�UNTY AND STATE OF •3EkV kgr5 C18POSA,L SY}TSM —_ GA ER OF, AND INTEND TO _ - DISCONNECT PLUG AND A I H'1 D (DENTIAS PROPERTY. gBAN DON HOUSE SEWER c �" ` _EE _ BACKF tLLSEPTIC TANKS ❑ -- SEEP.PITS) ❑ CESSPOOLS ❑ /" 4 VALIDATION CK. M.0. CASH 01"'JUL .9 ;L 0 i) .v ; 'BA8" APPLICATION FOR PERMIT 'Koo$ -8.88 7 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL 1 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. County Engineer ADDRESS CASSATT D. GIiiI'FiN.$up't of Badding LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO a ✓C. OWNER BLOCK TRACT s`'a¢ ADDRESS r NO.OF BLDGS. SIZE OF LOT 'Vt SNOW ON LOT CITY ' '. x / PEL.N0, s USE OF BUILDINGS f } �' y IJ DISTRICT NO GR)UP MAP PROCESSED BY K PG CONTRACTOR ADDRESS 3. Z k", CONNECTION DATA 4 CITY 4 -- TEL.NOS. {a P<.t j JSTATION DEPYH LL a REGISTRATION N0, rr; * r COUNTY STATE MANHOLE REFERENCE � _. , t x �- #tPPER NO. DESCRIPTION OF 'WORK FEE LOWER HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 SEPTIC TANK,SEEPAGE PIT OR Y. °CU TYPE OF Cq: -CTIOH LENGTH FROM PITS AND/OR DRAINFIELD a $3.00 _. P.L. M.L.TO FP.L. OVERFLOW SEEPAGE PIT,DRAINFIELD EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2,00 HOUSE SEWER CONNECTING TO :, P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 _20,IMP,NO. e '. , 70B N0, CONNECT OUSE SEWER BLDG.OR TRUNK PERMIT NO. ROAD PERMIT N0. WORK TO HOUSE SEWER @ $-9.00 _ _ ALTER,REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR DISPOSAL SYSTEM a $1.00 PERMIT NO, `INDUSTRIAL WASTE APPROVAL CHARGES OwNms PERS $ { 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. _ APPROVALS DATE INSPECTOR`S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING _ TO THE PUBLIC SEWER SIGNED THIS ,QDAY OF ig _ NEW HOUSE SEWER _ OWNER OR. CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ," SEPTIC TANK,SEEP,PIT(S) ADDRESS _AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _CESSPOOL❑ DRYWELLEI=I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER, REPAIR,SEWER OR PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDE6(T�AL PROPERTY. ✓ r x BACKFILL SEPTIC TANKS[] SIGNATURE SEEP.PIT(S) CESSPOOLS 01 OF PERMITTEE �p VALIDATION ROBERT A.WOOD CK. X.o. cAsx SUPERVISING MECHANICAL ENGINEER �,��f r. U�'.n dr .:'is•. 2/70, 6A%421) APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING I '77_�, JOHN A. LAMBIE, COUNTY ENGINEER BUILDING S COLEMAN W. JENKINS. SUPT. OF BUILDING L 'TY _2_�"c"- LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST (PRINT OR TYPE ONLY) L rF-5rRIFT;ON LOT NO..'�) OWNER 4, — MAIL BLOCK TRACT ADDRESS - 2 NO. OF BLDrS, SIZE OF LOT NOW ON LOT C?TY /;iiL� NO, I�CT N 1) GROUP CLASS MAP PP,OCESSED BY BU:LDINGS SK p GONTRAC zJ� ADDRESS CONNECTION DATA CITYTE TEL IN STATION DEPTH Z STATE LICk'l.P PER 'MANHOLE REFERENCE: LICENSE NO, CLASS LOWER TYPE.OF CONNECTION LENGTH FROM 6ESC IPT`ION OF WORK FEE NOT -TH-1�-U-E�ESE-W-ER--C(INNECTLNG TO Y. CURB P.L. M.L.TO P.L:' PUBLIC SEWER $5.00 NO. r 'INK.SEEPAGE PIT OR CO.IMP NO JOB NO,,-' PITS AND,OR DRA!NFIELD @ 510.00 TRUNK PERMIT'NO. ROA9,]PERMIT NO. �PRIVATE OISPOSAL SYSTEM @ $3.00 _ArFFFDAVIT 1 WA3 DATE --F�-,:EN NECT ADDiFi_6W_XE gLE�i-&4 1111111T 64iiD_lNSTW.NO, 0 KT.HOU S 1.1 E 11 ER @ $3.00 OVEN FLOW.SEEPAGE PIT DRAT)FIELD .�`{I. - � EXTN..CESSPOOI.ORT WELL.MA NH OLE:@ $500 1 HWY.OR ST.WIDENING A SEWER OR v @ S1.00 u PERMiT NO. INDUSTRIAL WASTE APPROVAL —A CHARGES OV;MR'S PERMIT 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE IHAVE AT THIS DATE: A CONTRACT W�rH THE HRF EEIN NAMED CON- RFJMBURSEMENTEE T EXISTING T 0 CON NECT THE ABOVE DESCRIBEX I ST.N D G DWE:LL ING T , 0 THE PUBLIC SEWER, APPROVAiS DATE SIGNATURE SIGNED THIS_DAY OWNER OR NEW HOUSE SEWER OWNERS AGENT-- N_lC iT 16 N A L DE Iss SUIL.DING OR WORK SEPTIC TANK,SEEP,P;T(S) I HERE�.W; ACKNOWLEDGE THAT I HAVE READ THIS APPLtCA,ION AND/OR DRAiNFIELO .. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTYORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEW E RS CESSPOOL 0 DRYWELL HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/CR ALTER, REPAIR.SEWER OR LICENS 0 AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM DESCRI IF CAL. ORNIA OR THAT I AM THE LEGAL OWNER OF. AND INT R E" END TO I CONNECT PLUG AND , JOE IN.• TPROPERTY. HEABOVE 19 ED RE 5 IKDENT iAL ABANDON HOUSE SEWER SIGNATURE OF FERMrTTEE BACKFILL SEPTIC TANKS SEEP.PIT tS) CESSPOOLS JACK R. ALLEN VALIDATION_"�. ..,, SUPERVISING MECHANICAL ENGINEER CK, M,O. .CASH t Ef= m