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Home My Public Portal About5241 PAL MAL AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 9491 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS ANGELES WILLIAM J. FOX. COUNTY ENOINEER BUILDING �n 1 ADDRESS r FOR APPLIC T T FILL I LOCALITY ,Lo_A,.I., _ 4 BUILDING NEAREST A 117 CROSS ST. _ LOCALITY DISTRICT NO. SERIAL NO. PERMIT NO. NEAREST ' A /�� J p s CROSS ST. 0 IjECEIVED�Y R.AdT I.,Inert+.tion GATE ISSUED OWNER } - p-'QLti-t... MAIL rV ADDRESS USEZONE OCCUPANCY BK MAP PG CITY TELAO. �- / I ( ` CONTRACTOR California Sewer Const.Co. CO.IMP.NO. 9 ADDRESS 1317 Colegrove Ave. JOB.NO. CITY Montebello TEL.NO.UNlon 11-5048 TRUNK PERMIT NO. REGISTRATION NO. 104445 S&QNTV ROAD PERMIT N0. LEGAL STATE ENCROACHMENT DESCRIPTION LOT NO. PERMIT NO. BLOCK ,O TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT 10.OF BLD68. IOW ON LOT CHARGES USE OF BUILDINGS CONN ECTIOfl CHARGE FEE NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOU BE SEWER CONNECTING TO - PUBLIC SEWER 6 8 3.51 RECEIPT NO. DATE BY H OUSE EWER CONNECTING TO PRIVATE DISPOSAL SYSTEM Im CONNECT ADDITIONAL BLDO.Ofl EXCEPTION RECORDED WORK TO HOUSE SEWER I.M ALTER OR REPAIR EXISTING NO- DATE BY SEWER OR DISPOSAL SYSTEM I.00 AND/ORDISPOSALAND S STEIAN MN HEW ER 1.00 CONNECTION DATA SEPTIC TANK.SEEPAGE PIT OR / PITS AND/OR GRAINFIELD 2.00 STATION 4ia` DEPTH CESSPOOL—DRYWELL ' SPECIAL CONDITIONS ONLY 2.00 17 � ) MANH hREFE RE NCE w 1 yV LOWER TYPE OF CONNECTIOJPI� LENGTH FROM ( (� -Y. ',HAG ( P.l�/ M.L.TO P.L. �J OWNERS PERMIT S i I DD AUTHORIZATION TOTAL FEE I 1-1-5-6 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THEP BLIC SEWER NEW HOUSE SEWER SIGNED THIS-1P.__._._ AY OF._. .._. ✓..._. 19.'� OWNER OR / CON NECTADDITIONAL OWNERS AGENT..'.. BUILDINGORWORK .. ... ._ SEPTIC TANK,SEEP.PIT(S) ADDRESS_.��. - _......--- _.. . ._ ...... .....:. AND/OR GRAINFIELD IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL(] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE El TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSALSYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REOUI RED By LOS ANGELES COUNTY AND AMADISCONNECT ABANDON HO PLUG PLU6 AND AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN ER OF THE ABOVE DESCFHIBED RESIDENTIAL PROPERTY. - BACKFI L L SEPTICTANK8 4 SIGNATURE / ., SEEP.PIT(8)� CE88POOL� 76A632D 663 1/53 24650 °EBOB TaeaA6.60 APPLICATION FOR PERMIT aD COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL 1 DEPARTMENT OF COUNTY ENGINEER r ��L / BUILDING AND SAFETY DIVISION SION o LD I'M L. OHN A. LAMEIE, County Enpyin..r - LLIAM A. JENSEN, Supt o!Euildi.9 LOCALITY 1 NEAREST FOR APPJ1 TO FELL IN CRoss ST. — LEGAL DESCRIPTION LOT N0. OWNER �rJ BLOCK TRACTADDRESSMAIL NO.OF SLOGS. SIZE OF LOT NOW ON LOT CITY EL. NO USE OF BUILDINGS DISTRICT NO.I GROUP YAPPROCESS BY K PG CONTRACTOR ADDRESS ��c CONNECTION D TA CITY Sr TEL.NO. STATION DEPTH STATE MANHOLE REFERENCE UPPER REGISTRATION NO. 1 COUNTY LOWER NO, DESCRIPTION OF WORK FEE HOUSE SEWER SEWER CONNECTING TOPUBLI@ $0.00 TYPE OF CONNECTION LENGTH FROM PIETS AND/OR DRPTIC TANK. AENFIELDT OR @ S3.00 Y. CURB P.L. Y.L.TO P.L. OVERFLOW SEEPAGE PIT.DRAINFIELD EXTN..CESSPOOL. DRYWELL @ $2.00 HOUSE SEWER CONNECTING TO P.C.NO. PRIVATE DISPOSAL SYSTEM @ 51.00 CO.IMP. NO. JOB NO. WORN TO HOUSE(SEWER LOG.OR @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO. p U ALTER REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SEWER OR OI SP 5 L YSTEM @ $1.00 PERMIT NO. ol INDUSTRIAL WASTE APPROVAL CHARGES OWNERS PERMIT 5 2 00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE G C REIMBURSEMENT FEE IHAVETHE HER91N NAMED CN. TRACTORA TO CIONNECT T EDATE AO NTRACT ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OF 19— NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERSAGENT BUILDING OR WORK - ADDRESS 4 SEPTIC TANK,SEEP.PIT(S) - AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SEWER 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND YSTEM LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON CT PLUGHOUSE AND CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE WER DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS ❑ SIGNATURE - I SEEP.PIT S) CESSPOOLS OF PERM ITTE ®r VAMATInid ROBERT A. WOOD CL R.G. CAstl SUPERVISING MECHANICAL ENGINEER �iv9326QD MR 8 3.00