The URL can be used to link to this page

Home My Public Portal About9023 PENTLAND ST_Sewer__ �CXI- Tan 6420 - CEBOB - 9/73 APPLICA ION FOR PE MIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING O 3 A D.... LOCALITY J� / . //,,`` FOR APPLICANT TO FILL IN CflO3655T C fJ C�(/y LEGAL DESCRIrT10N LOT NO OWNER MAIL BLOCK TRACT ADDRESS NO OF BLDG. SIZE OF LOT NOW ON LOT CITY TEL NO USE OF DISTR ICT NO GROUP BR MAP PS PROCESSED BY BUILDING. ['� /// CONTRACTOR 2 / \ 9s" _^'— ADOR.BB �� CONNECTION DATA CITY TEL NO STATION DEPTH STATE ��JJ LIC MANHOLE REFERENCE UPPER LIC[NHE NOGG. GLAaB�� LOWER NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB PL M L TO P L PUBLIC SEWER 0 $T 00 C NO SEPTIC TANK SEEPJAGE PIT OR PITS ANO/OR ORA INFI ELD O $ I0 GO CO IMP NO OB NO HOUSE SEWER CONNECTING TO _ TRUNK PERMIT NO ROAD PERMIT NO PRIVATE DISPOSAL SYSTEM 3300 CONNECT ADDITIONAL BLDG OR AFFIDAVIT KAZWOUll RECORD INSTR NO DATET WORK TO HOUSE SEWER O $3 GO d OVERFLOW SEEPAGE PIT DRAINFIELD O Q[TN CESSPOOL DRYWELL Q SS GO V ASR RE PAIR OR ABRNBOY HOUSE iHWY OR ST WIDENING BEWfROR�LSYSTEM 0 t30O STATE ENCROACHMENT "` _y Ls' •Y MANHOLE 0 $T 00 PERMIT NO Cl INDUSTRIAL W LL WASTE APPROVAL GO cHAncts OWNERS PERMIr s 00 CONNECTION CHARGE FEE + AUTHOATLATION rorAl FEE d 1 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 9SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT - CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK SEEP PIT(S)_ I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD AN DAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY WNTY ORDINANCES AND STATE LAWS REGULATINGPSEWERSCCSSPOO DRYWELL'❑RTIFY THAT I AMPRISTER[D ANO/OR wLTf REPAIR EWER OREOUIRE[ BY LOS ANLL COVNTY AND STATE OF 9EWA AL 8Y8TEM CTHAT I AN TX EG OWNER OP AND INTI NG TORE ABOVEOE E [BIOENTIA ROP[RTY DISCONNECT PLUGABANDON HOUSESEWER S ILLSEPTICTANKSE SQCP SI ❑ CQBiPOOL3 VALIDATION , CK M o cAaH 'OP.KLSCOMPENSATTO ,9 9 4 nJUN It> s u_ 1 4.0 0 Au LICY HOLDER " LICY-NUMBER, 30/2.o DF.PARTAlENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1 DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION COUNTY OF LOS AMORT-Es WILLIAM J. FOX, COUNTY ENGINEER BUILDING G ADDRESS FBUILDING OR APPLICANT TO FILL IN ///] LOCAL ,,m 1 NEAREST ADDRESS / DaU �,[,.�{[�_d" NI CROSS ST 1Q,Pin.. %. ti IY`6J1 LOCALITY 1 �h �D ESTe 'j DISTRICT NO SERIAL NO PERMIT NO CROSS ST �w-LcKG�.pI A '� S RECEIVED BY Rndy for ler0�ien DATEISSUED OWNER 4 'C'A In —2� MAIL USE ZON OCCUPANCY BK MAP PB ADDRESS CITY TELHO A_1 CONTRACTOR O� <J[-j yLi.� IMP MO ADDRESS q/3 �,�.. „� I JOB NO CITY L>c" .F ELpNO /'s;- ! TRUNK PERMIT NO REGISTRATION NO �� aL 0 / COUNTY ROAD PERMIT NO LEGAL STATE ENCROACHMENT DESCRIPTION LOT NO PERMIT NO BLOCK TRACT INDUSTRIAL WASTE APPROVAL SIZE OF LOT NO OF BLOBS CHARGES NOW ON LOT USE OF BUILDINGS CONNECTION CHARGE FEE NO DESCRIPTION OF WORK FEE REIMBURSEMENT FEE H OUSE SEWER CONNECTING TO PUBLIC SEWER @ s 350 RECEIPT NO I DATE By HOUSE SEWER CONNECTING TO t/ PRIVATE DISPOSAL SYSTEM 100 CONNECT ADDITIONAL BLDG OR EXCEPTION RECORDED WORK TO HOUSE SEWER 100 MO ALTER OR REPAIR EXISTING DATE BY SEWER OR DISPOSAL SYSTEM 100 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 100CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR , PITS AND/OR GRAINFIELD 400 CC STATION DEPTH CESSPOOL—DRYWELL B PECIAL CONDITIONS ONLY 400 MANHOLE REFERENCE y, UPPER LOWER TYPE OF CONNECTION LENGTH FROM OWNERS PERMIT s 1 r cufla PL M L TOP L 00 AUTHORIZATION TOTAL FEE CIG I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS_ _ —_DAY OF _ 19_ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT _ _ _ _ __ _ _ _ _ __ _ BUILDING OR WORK / SEPTICTANK,SEEP PIT(S) ADDRESS _ _ _ _ _ _ _ _ JREGISTERED __ AND/ D !�/J I HEREBY ACKNOWLEDGE THAT I HAVE REPPLI- CESSPOOL[] DRYWELL M CATION AND STATE THAT THE ABOVE IS CORRGREE TO COMPLY WITH ALL COUNTY ORDINANCES ALAWS ALTER REPAIR SEWER OR REGULATING PLUMBING AND SEWERSSEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLERED DISCONNECT PLUG AMDAND/OR LICENSED AS REQUIRED BY LOS ANUNTY ABANDON HOUSESANDANDSTATE OF CALIFORNIA OR THAT 1 AM THOWNER OF THE ABO](E DESC IBED RESIDENTIAL BAC IL 8 PTIC TANK E]GV1 `/J��",r_..[ BEEP PIT(S)E] CESSPOOLSBIONATU �OFPERMITTEE _ _ 76A6e3A 663 7/53 11384 a 9&e 86 APPLICATION FOR PERMIT 1 aaDIVISION OF BMDING AND SAFETY SEWER—SEWAGE DISPOSAL Dop.lmant of County Engine: County of Los Angeles BUILDINGv .JOHN A LAMBIE COUNTY ENGINEER ADDRESS T) CASSAT71D GRIFFIN SUPTOFBUILDINO LOCALITY A RE FOR APPLICANT TO FILL IN CR059 ST LEGAL (9 DESCRIPTION L01 NO F7?�///A�1 rj. 14d—ir_—S/-3 OWNER Cs v MAIL BLOCK TRACT--7,& ' S'� -�j-13 ADDRESS NO OF BLDGS CITY EL NO SIZE OF LOT NOW ON LOT BUELOFNG9 DISTRICT NO GROUP MAP c� CONTRACTOR CALIF SEWER CONST CO '� _ PG� ADDRESS 1317 COLEGROVE AVE cot CTION DATA CITY MONTEBELLTCEL NO PA 1-5048 STATION DEPTH MANHOLE REFEREN C; / 1-�(j AA Ly ❑ STATE l J REGISTRATION NO 1:.x-1 ❑ COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF COH NELTI01 LENGTH FROM PUBLIC SEWER 9 $300 Y CURB P L M L TOP L SEPTIC TANK SEEPAGE PIT OR PITS AND/OR GRAINFIELD ® S 3 00 _ OVERFLOW SEEPAGE PIT GRAINFIELD P C NO EXTH CESSPOOL DRYWELL ® S 2 00 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM ED S 1 00 TRUNK PERMIT NO ROAD PERMIT NO CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER $1 00 PERMIT NO ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM ® S 1 00 WASTE APPROVAL CHARGES _ CONNECTION CHARGE FEE OWNER'S PERmrr s o AMOMATION ITOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THI Y OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGE SEPTICTANK SEEP PIT(S) ADDRESS AND/OR GRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWEROR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AM PROPERLY GISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REOUIRED DY NGEL C TY AND S TE OF CALIFORNIA OR THAT I TH LEG 0 R OF TH ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIA ROP BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(5) ❑ CESSPOOLS❑ _ OF PERMITTEE JOHN A LAMBIE COUNTYE 1 ATION ROBERT A WOOD CHIEF PLBG INSPECTOR CF ■ a [A9H �5835v; AFR281 0 A 5,00