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Home My Public Portal About5554 PAL MAL AVE_Sewer__ C6GSS eE APPLICATION FOR PERMIT TeAEAaD COUNTY OF LOS ANGORS DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION BUILDING WMALAbMM C.t7 EDquo�r ADDR.D WU.LI/lId A IE[7S=, Sup t d Bw1dmg LOCALITY N[AR[DT FOR CANT TO ML IN CROSS ST p[DCRIPfIOX O NOtrz, OWR[R NAIL BLOCKTRACT ADDRESS NO OF BLDG° SIZE OF LOT NOW ON LOT CITY TQ NO use or BUI LOINOD DIDTNCT GI..OUPl LP MAP ♦ PROCESSED BY K COMRACTOR ADDRED CONNECTION DATA CITY L NO Q ON s- DEPTH S STATE MANHOLE REFERENCE U1TE REGISTRATION NO L COUNTY No DESCRIPTION OF WORK FE! PE OF NN LENGTH P M `1 � } HOUSE SEWER CONNECTING TO PL ML TOP V 3y PUBLIC SEWER 41 {S DID PC NO SEPTIC TANK SEEPAGE PIT dt CO IMP NO JOB NO PITSAND/ORDRAIXFI[LD Q 11000 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERM NO PRIVATE DISPOSAL SYSTEM 63M CONNECT ADDITIONAL BLDG OR AFFIDAVR 7=CORD R[CORO IXSTR NO OAT[ WORK TO HOUSE SEWER C 53M OVERFLOW SEEPAGE PIT GRAINFIELD [ETN CESSPOOL DRYW[LL MANHOLE O 55M ALTER REPAIR OR ABANDON HOUSE HWY OR DT WIDENING SEWER OR DISPOSAL SYSTEM C Si 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL W [AP VA OWNER'S PERM T siAMW oNNECTNJN CHARGE FE! AUTHORIZATION roTAL FEEI HAV! AT THIS OAT[ A CONTRACT WITH THE H[REIH CON REIMBURSEMENT FEE TRACTOR TO CO NMICT THE ABOVE DESCRIBED EXISTING DWELLING *n O� TO THE PUBLIC SEWER AP DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF IE_ OWNER OR NEW HOUSE SEWER �•j /'�f+}-I. OW NeRG AGENT CONNECT ADDITIONAL I ADDRESS °U ILDING OR WORK I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION B[PTICTANK SEEP PIT(G) AND STATE THAT THE ABOVE IS CORRECT AND AOR![ TO COMPLY AND GRAINFIELD WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ ORYW[LL ❑ 1 HEREBY 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 CA FOR NIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO DISCONNECT PLUG AND REDID[ IN THE ABOVE D[S6RISED RESIDENTIAL PROPERTY ABANDON HOUSE SEWER SIGNATURE OF FERMI SACKIILL SEPTIC TANKS ❑ D[!P PTTISI ❑ C[KPOOLJ Uc. AMATION ROBERT A WOOD M 0 CASH SUPERVISING MECHANICAL ENGINEER CK M O CASH U"2 6 9 OG l;AR29 1 0 0 7.00- `_` * nt/ C6APPLICA-nibl" FOR PERMIT >BAeAS42D m U COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DrMION 7ADDR968 _ A ))DHN A TAMB IE CGGD EB Sar '0 . WNSIAM A IENSEN 8ny f A r mq FOR APPLICANT TO FILL IN CROST LECAL DESCRIPTION LOT NO4:2 '(/ y.� OWNERBLOCK TRACT SIZE OF LOT CITY TEL NO u5mOF TRICT NO GROUPMAP PROCCBCtO BY DINO° /O BK PO CGNTRARG w.Dnces CONNECTION DATA CIT TEL NO / 3a T N DEI[H eTnTEt �D uP R REGISTRATION NO COUNTY MANHOLE P[F[R[MC NO DESCRIPTION OF WORK F![ pEo Ory LENGTHoM HOUSE SEWER CONNECTING TO Y L ML TO• PUBLIC e[W!R aB OD SEPTIC TANK SEEPAGE PIT OR PC NO v P ITS AND/OR GRAINFIELD SIO OD CO INP MO Pc XO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM 0 [S 00 ' CONNECT ADDITIONAL BLD. OR AFFIDAVIT RM[[[ [[[[R[rt RECORD IN6TR NO DATE WORK TO HOUSE SCWE R 0 [S 00 OVERFLOW SEEPAGE PIT GRAINFIELD EXTN CESSPOOL DRYW[LL MANHOLE Q S°00 ALTER .FAIR OR AtANOON HOUSE HWY ORGY WIDENING SEWER R015PO16keYSTEM 0 3e 00 STAT.ENCROACHMENT PERMIT MO INDUSTRIAL wArte wPPRovAL OWNEFrs PERMIT fRcm AUTHORIZATION TOTAL FEE C NNECTION CHARGE FE[ 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO I° CONNECT THE ABOVE DESCRIBED EZTIMO DWINO BLLAPPROVAL) TO THE PUBLIC SEWER DATE INSPECTOR°SIGNATURE SIGNED THIS DAY OF IS_ OWNER OR NEW HOUSE Q L• �� OWNERS AGE NT CORRECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AID/OTANK SCEP PIT(S) AND BTATC THAT THE ABOVE IS CORRECT AND AOREC TO COMPLY AXD�OR GRAINFIELD WITH ALL COUNTYORDINANCES AND STATE LAWS R{OULATINO PLUMBING AND SEWER° CESSPOOL ❑ GRYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER REPAIR SEWER OR LIC EO AS RCOUIRID BY LOS ANGLES COUNTY AND STATE OF °EWAO E DISPOSAL SYSTEM CALIFORNIA OR THAT I AM TH{ "GAL OWNER OP ANO INTEND TO DISCONNECT PLUG AND RESIDE IN THE AB D[1LRI B[D R! 1 NTIAL ROP[RfY DISCABANDONDISCONNECT PLUG AND WER aIONATURe BACKFILL S[PfIC TANKS ❑ OP F¢RMITT6[ SEEP PITISI ❑ CESSPOOLS VALIDATION ROBERT A WOOD cK M O cwsH SUPERVISING MECHANICAL ENGINEER Lj�269lt2 = 2911 0 2500- t `E°°°° °E APPLICATION FOR PERMIT TeweAaD COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEEB SEWER—SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION eU1LDINa �� WMA LAM M CrEB Bn •DOR[Ss W6UAM A TEMEN BuP f rl B�Idra9 LOCALITY MEREST FOR CANT TO FILL IN cwoeB m L ow DE RIM OM OWNER MAIL BLOCK TRACT ADDRESS No OF SLDGS elze o1 LOT NOW ON LOT f TEL NO SUI OF CT NO OPO MAP PROCma D BY PG waomca R CONTRACT R ,�a- /2 ADDRESS CONNECTION DATA CITY [L NO 6� N DEPTH 91 SLE REFERENCE P REGISTRATION NO C No DESCRIPTI F WORK FCC eoFc a o LENGTHov oM y HOUSE SEWER CONNECTING TO ML TO L PUBLIC SEWER 55M SEPTIC TANK 9CEPAOE PIT OR PITSANO/OR Oww INFIKLO d {1000 NOHOUSE SEWER CONNECTING TO PERMIT NO ROAD PERMIT NO �( PRIVATE DISPOSAL SYSTEM 5800 GAJ CONNECT ADDITIONAL BLDG OR JAFFIOAVIT WAIT[T [.MTB[IR RECORD IMSTR NO DATE WORK TO HOUSE SCWEw 0 {800 OVERFLOW SEEPAGE PIT GRAINFIELD [ITN C"OPOOL DRYWHLL MANHOLE ES 00 ALTER REPAIR OR ABANDON HOU.[ RST WIDENING SEWERORDISPOSAL SYSTEM 0 {800 ENCROACHMENT T NO TRIAL APPN VAOWNws PEAMIT f 2 S.AUTHORIZATION TOTAL FEF CTIOn CELLAE FEC I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN N M[D CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING E AI)IYtt OVAE� TO THE PUBLIC SER DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF IG_ OWNER OR NEW HOUSE SEWER OW NERB AGENT_ CONNECT ADDITIONAL BUILDING OR WORK A ADDRESS SEPTIC TANK GRA EFIEP PIT(S) 1 HSTABY THAT THe ABO THAT 1 HAVE READ THIS ATO CO TION AND/OR GRAINFIELD AND STATE THAT THE DIVA IE CORRECT TE LAWS[ E COMING WITH ALL COUNTY ABOVE AND STAT[ LAWS REGULATING PLUMBING AND SSWERB CESSPOOL ❑ DRYWCLL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR ALTER REPAIR SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STAT[ OF SWAG[DISPOSAL SYSTEM CALIFORM IA OR THAT I A THE LEGAL OWNER OF AND INTLND TO DIECONN[CT PLUG AND RC°IOe IN THE AB V[ DESCRIBED REST ENTIA PROP[RT ApArypOry HOUS[BEWER •IONATURE ❑ OF P[AMTTT[ BACNIILL SEPTIC TANRS {EHP PITltl ❑ CGSEIOOU VALIDATION ROBERT A WOOD cK M o CASH SUPERVISING MECHANICAL ENGINEER L�CO2 6 8 Er. 17,R29 1 0 D 7.00~ 7 A8420 1 APPLICATION FOR PERMIT pA°AED COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENTIN OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING Wm)OHIf LAbWlE Cp®tT EngL.. T ADDRESS bA A, MRSM, SMP t of 13161—[ LOCALITY NGRCBT FOA CANT TO FILL IlY '2IMO;E�a 49e L CROtB BT DEIEGAL ry T o OWNER MAIL [LOCK TRACK ADDRESS NO O LDOB SIZE OF LOT NOW ON LOT CITY T[L NO F O USE DISTRICT NO GROU MAP FROCC$DE0 BY USE OF O6 N SK PG CONTRACT (J// '��/2.5 ADDRESS CONNECTION DATA CITY CL NO �d�(/ N DEPTH 'S/ BTATE MANHOLE ReFER[NC[ REGISTRATION NO ` COUNTY No DESCRIPTION OF WORK FE[ TY OF CO o LENGTH I M HOUSE$EWER CONNECTING TO Y M L TOP PUBLIC SEWER 0 85M PC NO SEPTIC TANK SEEPAGE FIT OR PIT$AND/OR GRAINFIELD Y EI000 CO IN, NO JOB NO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT MO PRIVATE DISPOSAL SYSTEM 0 s300 CONNECT ADDITIONAL SLOG OR AFFIDAVIT 1 R.GT.s .a.PU1T I RECORD IN[TR NO DATE WORK TO HOUSE SEWER 0 93W OVERFLOW SEEPAGE PIT GRAINFIELD [XTN CES[POM DRYW[LL MANHOLE 0 S500 ALTERAIR ORAMNDONHOU E HWY ORST WIDENING SSW OR DI°F A SYSTEM 0 5300 $TAT[ENCROACHMENT PERMIT NO INDUSTRIAL W APPROVAL OWNER'S PERMIT s ` AUTHORIZATION TOTAL E CONNECTION FECHARGE FEB 1 HAVE AT THIS DATE A CONTRACT WITH THE ry[RlIN NAMED COX REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED [;16TIN0 DWELLING I�T�E� TO THE PU[LIC SEWER A"ROTr`. AALS DAT[ INSPECTOR 5 SIGNATURE SIGNED THIS DAY OF Ip_ OWNER OR j EW HOUSE SEWER OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS SUILDINO OR WORK SEPTIC TANK $[EP PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE REPLICATION AND/OR GRAINFIELD AND STAT[ THAT THE ABOVE Is CORRECT ANO COMPLY WITH ALL COUNTY ORDINANCES AND STATEGULATING PLU No AND SEWERSCESSPOOL ❑ DRYWELL ❑ 1 N[R[SY CERTIFY THAT I AM PROPERLYD AND/OR ALTER REPAIR SEWER OR LICENSED AS fli0U1R[D BY LOS ANGLES COSTAT[ OP SBWAO[DISPOBAL SYSTEM CALIFORNIA Ofl THAT 1 AM THE LEGAL OWNEIM[ND TO 0SCONN[CT PLUG AND PlS10E IN THE A ! DE IS[O R[SIOINTTY ApAMDOR ry0U8l SEWER SIGNATURE ❑ OI PERM BACKFILL SEPTIC TANKS SEEP PIT(8) ❑ C[BSPOOLS ATION ROBERT A WOOD cK Y O CASH SUPERVISING MECHANICAL ENGINEER LpLO 2 6 8 9 to FAR 2 9 1 1 D 2 5.0 O" v