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Home My Public Portal About6335 PRIMROSE AVE_Sewer__ J () 6 2 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL Ipjf DEPARTMENT Of COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING , JOHN A. LAMBIE, County Engineer ADDRESS c WILLIAM A. JZNSEN, Sup't of Building LOCALITY Lo� 1,1,�l' T- FOR APPLICANT TO FILL IN cROSs s7. LEGAL DESCRIPTION 1 O NO, OWNER MAIL BLOCK TRACT ADDRESS NO. OF SLOGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. S i DISTRICT NO. GROUP1 BK PG PG PROCESSED BY CON,RACIOR ADDRESS p L- CONNECTION DATA CITY STATION DEP-H - STATE IlAi 1IFFE ENC U�POR Fl,r i OUNTY LOWER DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM. Y. CURB PL. M,LTO P.L. PUBLIC SEWER @ $5.00 P.C.N 0. 0 SEPTIC TANK,SEEPAGE PIT OR i AND"OR GRAINFIELD SID Co.IMP.1110, JOB NO. HOUSE SEWEP cONNi ENG TO PRIVATE DISi SYSI EM $3.00 TRUNK PERMIT'NO ROAD PERMIT NO. 0 ONNECT RUE!TIONAi lli OR AIVER EASaN,t NTDATE In OR K TO HOUSE SEWER @ SS.00LE PI � OVERFOW SE DRAINFIECD EXTN.,CE:SSPOOL,ORYWi MANHOLE 0 55 00 A L HWY.OR ST.WIDENING TER. �PAIR OR ARANO _j I DISPOSAL SYSTEM-H WE R OR $3-00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WAS!i�VA!-' `S OWNER FI MIT 21 00 [-.,-- CONNECT ION CHARGE FEt 0, AUTHORIZATION Ti FEE I I I HAVE AT THIS DATE A CONTRACT ITH THE HEREIN NAMED CON- R_E�IMMIIBURSEMENT FEE TI :7- -_- B DESCRIBE �CT ABO V@:TO CO CNE THL A VE '�'ELL IN _.___SSSS_ THE PU B L;C SEWER. APPROVALS ,ATE INSPECTOR'S SIGNATURE SIGNED THIS.—. DAY OF--------19-- OWNER OR hi v, NEW HOUSE SEWER OWNERS AGENT— ------ - CONNECT ADDITIONAL BUILDING OR WORK SEPTIC TANK,SEEP.PIT(--) HERi THAT I HAVE READ III!$ APPLICATION SvAi THAT THE Ai 15 CORRECT AND AGREE TO (�OMPLY Ai t>RAiNI`ICi WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATIN13 PLUMB ING AND SEWERS. IRS, CESSPOOL D 01 I HEREBY CERTIFY THAT IAM PROPERLY REGISTERED AND/OR -Z-i REPAIR,-SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND 5 TATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT j AM THE LEGAL, QAVNER OF, AND INTEND TO • TIA AND Ri IN, THE ASVf DESCRIBED IDEN L PROPERTY, ABANDON HOUSE SEWER SIGNATURE OF PERMITTEE BACKFILL_SEPTIC TANKS 0 SEEP.PlTi-- [3 CESSPOOLS VALIDATION ROBERT A. WOOD CK. M.O. C AS H SUPERVISING MECHANICAL ENGINEER •t' I `6A6 ?FiA676A6420142-bz APPLICATION FOR PERMITT-' COUNTY OF LOS ANGELES SEWER-SEWAGE [DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION B UILDING JOHN A. LAMBIE, County Engineer ADORE WILLIAM A. IENSEN, Supt of Building, r TY FOR APPLICANT TO FILL IN 5T'. - --- - - - - _ - --_ LEGAL - - -- ` DESCRIPTION LOT N CW NER C� -r q' MAIL BLOCK. TRACT tr .ADDRESS NO. OF' SLOGS. SIZE OF LOT NOW ON LOT.__ r} 1 CITY TEL. NO. USE OF BUILDINGS --j" DISTRICTNO, GROUP MAP PROCESS ED HY BK PG CONTRACTOR j 7 e '1' ; 7 ADDRE s { - CONNECTION DATA - — 7—CIT - - d STATION DEPTH - e�STATE: MANHOLE REFERENCE REGISTRATION N1 '-/ - _- I� O_I,1N7Y LOWER -- NO' DESCRIPTION OF WORK fi--FEE.__ _ TYPE OF I,dNNE"CTION .--.--. _-_LEPJGTN FROM HOUSE SEWER CONNECTING T O ! Y. CURB P L. WE O F L_ 'U. U BLiC StW ER __ @ _$5.:00 _ _ L.__._ P.:;.NO _ ��- S'EPTiCTANIti,SEEPAGEPIT OR PITS AND/OR DRAINFIELO @ $10.00 j CO. MP NO. ,:E3trN0 I ?,9 HOUSE SEWER CONNECTING TO :'. �53.00 ,:NIC PERMIT NO.' `Ha.AD PA_`-R'M T'fiNb: PRIVATE DISPOSAL SYSTEM � � ' _. _ AFFIDAVIT CONVECT AJDI7iONAL BLD:s OR 1 A�FIDA VIT WAIVER eaaeMCHT HECgRD 51NSTR NO, - BATE WORK TO HOUSE SEWER $3,00 - _ I OVPftFL:O'vV 5CKYAC.E PIT.DRAiNFiELD � _ iF%T N.,.CES SPOOL.D4YWELL..MANHOLE� $5.0___0 0 HWY. OR.ST.WIDENn:ING ff§—_ - AL,7R PAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM Cti' $3.06 STATE ENCROACHMENT •`�- -- PERMIT NO INDU ST R7AL } `„/ . `- r� WASTE PROVA a y OWNER`S PERMIT $ AUTHORIZATION TOTAL FEE , R !4Ry_sSFMZNT F"EE � i HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- �----- 'ry ,/�,�r ' TRACTOR 7O CONNECTTHE ABOVE D E5C RIBtD .F PPROVALS'~_ EXISTING DW FILLING - T'O THE PUBLIC SEWER, ATE. 1 INSPECTOR'S SIGNATURE SIGNED THIS._ DAY .-- OWNER OR �. NEW;HOLSL "c.WER r OWNERS AG.ENT____-- ._ --'�/'--.._— _--- CONNECT ADDITIONAL ADDRESS BUILDING OR WORK S[PTIC TANK;SEE PIT(5) I HEREBY ACKNq Wf_EDG�K 79i:AT 1 HAVE RFAi3 THIS APPLr ATION ANO,AOR DRAINF'IFLD I I.NU TATf_ THAT THE'. ABOVE IS HREruT AND AGREE 70 COMPLY WITM# ILL COUN Y ORDINANIE3 AND STATE LAWS REGULATING ".MSINt> AND SEWERS CESSPOOL L, DRYV✓EL,L t� I HEREBY CEPT(FY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR L I C£NSED AS REQU;?RED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM ++ ' CALIFORNIA OR THAT I. AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND R EST OF IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY, 1 ABANDON HOUSE EWER. SIGNATURE "' i ';. tI y - ,�. BA YFiLL SEPTIC TANKS (� OF PERMT7'TFE ,.E P.F tT(S) �.� CESSPOOLS I VALIDATION ROBERT A. WOOD CK. M.o. Cnsw SUPERVISING MECHANICAL ENGINEER ' j' EGOS 3-162 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL BUILDING AND SAFETY DIVISION [7BWLDING JOHN A. LAMBIE, County Engineer WILLIAM A. JENSEM Supt of I.§uilding LOCALITY NEAREST FOR APPLICANT TO FILL IN __SR?F,S ST� 4 LOT NO. 41 OWNER _j _L1 MAIL -Z BLOC'K TRACT j Z� ADDRESS NO. OF SLOGS. SIZE. OF LOT NOW ON LOT —ftJ ,l/ CITY TEL. NO. USE OF BUILDINGS C15TRICT NO. CR 0 U PMAP PROCESSED 9Y 1 EIK PG CONTRACTOR ADDRESS -CONNECTION DATA CITY STATIONf. DEPTH STATE7vSNsi FE CE, UPPER C�q, E REG�S`IRA710N NO, COUINTI c LOWER NO. 1 IDESCRiPTION OF WORK FEE TYPE OF I*FQrTi. 1 LENGTH FROM HOUSE SEWER CONNECTING TO Y. M.Ll TO P.L. PUBLIC SEWER Q $3.00 0 SEPTFC TANK,SEEPAGE PIT OR PITIAND/Op,DRAINFtELD @ SIO CO.IMP, NO. v--z;4Q. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT N PRIVATE DISPOSAL SYSTEM @ $3.00 0 CON-N F&T ADD/TION---A L 13-00--G-.--0 R RECOR&: NSTFi.NO. 7.ATP - WORK TO HOUSE:SEWER $1.00 1 OVERFLOW SEE PAGE PM IM DRNFIELD FXTN.,C.ESSPOOL,DRYWET_L.MANHOLE. $5 I ER.RE?AIR OR ABANDON HOUSE HWY, OR T.WIDENING ZZ nOWER OR DIS-OSALVSTEM @ $3.00 STA-TF ENCROACHMENT L PERMIT NO- IN O� INDUSTRIAL 4- WASTE APPROVAL CHARGES O"ER'S PERMIT i 21 00 CONNECTION CHARGE FEE iUTH6'PJZATION -TOTAL FEE I HAVE AT THIS DATE. A CONTRACT WITH THE HEREIN NAMED CON REINIBUR5EMENT FEE: TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING _ 10 T H E P UB L IC SEWER- APPROT VALS DATE INSPECTOR'S SIGNATURE SIGNFD THIS DAY OWNER OR NEW HOUSE SEWER OWNERGAGENT CONNECT ADDITIONAL BUILDING ON WORK AOOFIE36 HEREBY ACKNOWLALOGE THAT I HAVE READ THIS APPLICATION SEPTiG TANK,SEEP,PIT(S) D THE ABOV AND/OR DRAINFIELD AND STATE THA_( 6, 15 CORRECT ANO AGREE TO COMPLY WITH ALL NlY ORDINANCES AND STATE LAWS REGULATING CESSPOOL, DRYWCLL PLUMBING AND SEWERS. HEREBY cERTH`Y THAT AM PROPERLY REGISTERED AND"'OR ALTER,REPAIR.SEWER OR i I LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM C 'RNiA THAT _At IF0 OR , I:AM 7HE 1-EGAL OWNER OF, AND INTEND TO —""i`"- DISCONNECT RESILE_ IN, THE ASOV# DES,_-Rfs IAL PROPERTY. LIP LUG AN DO N HOU R SIGNATURE —----- 0 _7 0 L BACKFILL SEPTIC TANKS A13AN SE SEVVF F PERMITTEE SEEP.PIT f 9) CESSPOOLS VALIDATION ROBERT A. WOOD CKI-,/' m.O. CASH SUPERVISING MECHANICAL ENGINEER