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Home My Public Portal About6503 ROSEMEAD BLVD_Sewer__ 'CAAPPLICATION JOR PERMIT 1 DIVISION OF BUIMING AND SAFETY SEWER—SEWAGE DISPOSAL Depoartam.nt of Comte Engmwr County of Enz=*" ADDRESS JOHN A LAMBIE COUNTY ENGINEER ADDRESS m CAB IATT D GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS ST LEGAL DESCRIPTION LOT NO OWNER BLOCK TRACT - PAIL ADOREBB SIZE OF LOT NO OP SLOGS CIT. TEL NO NO ON LOT USE OF BUILDINGS DISTRICT NO GROUP YAP BK PO CONTRACTOR O SA/ VIA ADDRESS CONNECTION DATA// STATION DEPTH f0 CITY TE NO MANHOLE REFERENCE / UPPER TE OWER REGISTRATION NO COUNTY NO DESCRIPTION OF WORK FEE If ROUSE SEWER CONNECTING TO TYPE OF CONNECTIO LENGTH FROM PUBLIC SEWER @ S 3 50 Y CURB P L Y L TOP L SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELD ® 3 S 00 OVERFLOW SEEPAGE PIT DRAINFIELD CO IMP NO' JOB NOO RTX CESSPOOL ORYW ELL MANHOLE @ 1 200 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM ® $I 00 TRUNK PERMIT NO ROAD PERMIT NO ADDITIONALCONNECT BLDG OR WORK TO HOUSE SEWER ® S 1 00 STATE T NO ALTER REPAIR OR ABANDON HOUSE INDUSTR SEWER OR DISPOSAL SYSTEM ® 1100 WASTE APPR R6E9 CONNECTION CHARS E OWNER'S PEHb= s 1 DO AUTHOMATION TOTAL PES REIMBURSE mT FEE I HAVE AT THIS DATE A CONTRACT WITH T HEREIN XA IED CON OVALS DATE INSPECTOR$SIGNATURE TRACTOR TO CONNECT THE ABOVE DE EKISTING DWELLING TO THE PUBLIC SEW XEW HOUSE SEWER _ SIGNED THI Y OF 1 OWNER OR BUILDING OR WORK AL OWNERS AGE SEPTIC TAN K,SEEP,PIT(S) ADDRESS_ E AND/OS DRAINFIELD I HEREBY A INOWLEDGE THAT 1 HA E READ THIS APPLICATION CESSPOOL❑ ORYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT 1 AY PROPERLY REGISTERED ANO/OP DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ST E OF ABANDON CT PLUGHOUSE AND CALIFORNIA OR THAT 1 AN T E E AL OWNE TH ABOVE DESCRIBED RESIDENTWER P BACKFILL SSMYWIWIY� SIGNATURE CESSPOOLS 911 OF PERMITTEE JOHN A LAMBIE, COUNTY ENGINEER VWMATIDI>ti,_-,j ROBERT A WOOD CHIEF PLBO INSPECTOR u ■ 0 <o✓J 1 7 9 1 @i ,IUI011 _ 4 A 450 IR (E°°° 1'° APPLICATIOFI FOR PERMIT TeA a+zD COUNTY OP LOB ANGELES SEWER WAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION I SUTLDINO / JOHN A LAMBIE COUNTY ENGINKKR � ADDRESS 6503 RoBemAad Blvd, COLEMAN W JENKINS SUPT OF BUILD ADDRESSNG r LOCALITY TgOle City ...REST FOR APPLICANT TO FII.L IIIc �, CROSS BT DUCRIPTHON LOT No , OWNER 9 IIB ITioilBtlRCtiOn Coo MAIL BLOCK TRACT �i ADDRESS p� BLDG. 8 SIM OF Lor ON,LOT CITY TEL No USE DI DISTRICT NO GROUP MAP TIDED BY tUILOINpa BK Pp CONTRACTOR a I O olnco ADDRESS 6 IiIOPI;Il $81dwt Avenue CONNE- DATA CITY Monte TEL NO WOM STATION d DR"" J `TATE[[ NO CLASS TATE LIC MANHOLE REFERENCE / UPPER NO DE6CR IO OF WORK FTE TYPE OF CONNECTION LENGTH FROMS/ HOUSE SEWER COEMERGVO TO O Y CURB L ML TOP L PU°LIC SEWER O { 00 SEPTIC TA NK PApT PIT PC NO PITS AND/OR GRAINFIELD O {TOGO CO IMP NO JOt NO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO d PRIVATE DISPOSAL SYSTEM O B°00 O CONNECT ADDITIONAL°LOO OR AFFIDAVIT RYTHI LULSIRT RECORD INSTR NO DATE CD WORKTO N OUS[SEWER O 11300 OVERFLOW SEEPAGE PIT GRAINFIELD CD [XTN C[SSPOOLDRYWELLMANNOLEO °BOO HW,�. ORST WIDENING ALTER REPAIR OR ABANDON HOU W SEWER OR DISPOSAL SYSTEM O 11300 STATH ENCROACHMENT 1 PERMIT NO = INDUSTRIAL WASTE APPROVAL CHARGES OWNERIT sS PERMOo AUMORTLATION TOTAL FEE O CONNECTION CHARGE I[[ I HAVE AT THIS DAT[ A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TOCONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVAL) TO THE PUBLIC SEWER DAT( 1 PCCTOESSIONATUR[ SIGNED THIS DAY OF I9_ OWNER OR NEW HOUSE SEWER OWNERS wGKNT_ CONNECT ADDITIONAL ADDRESS tU1L0IM0 OR WORK SCPiIC TASK SEEP PITISI I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ARDOR DRAINFI P AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLU MRINO AND S[W[RS CESSPOOL ❑ ORYWELL ❑ 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AMD/OR ALTER REPAIR SEWER OR LICENSED AS REOUIR[D BY LOS ANGLES COUNTY AND STAT[ OF SEWAGE DISPOSAL SYSTEM ULIFORN4 OR 1 AM THE LEGAL OWNER OF AND INTEND TO RESIDE IN TN° CRI D PCS IAL PROPERTY DIKONNECT PLUG AND ABANDON S) SEWER STp NATURE OF PERMITTEE °ACKPILL SEP�IC TANKS ❑ BE(F Prt(a1 L.l cwPooLS VALIDATION JACK R ALLEN CK \M O CASH SUPERVISING MECHANICAL ENGINEER y Q tr 9 4 n o/t Iran E ,. w n 0 GG 0 1 AC09 4 1 ors -M 51 o D 10 .0 0 �Q TeArogD-CESGS-JG-TI APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADORE" LocALrtr FOR APPLICANT TO FILL IN cno�{eT F �, � ,, ON LOT NO OWNER LouiV MAIL 05 Arlinto TRACT ADDRESS OT „0W o„OT6 CITY Riverside TRL 6J14)684-8870 BUILDINGS DISTRICT No SROUI MAP ESSED BY �` BR PD ORS,OQ ADDRESS j . WOOdb Rd V (/ CONNEC170N(ODASA clTr AltadenaTEL NG 98-8948 STATION f6o DEPTH LICE LIC - MANH OL[REFERENCE L�1 UPPER LICENCE NO CLAt OWER NO DESCRIPTION OF WORK F[[ TYPE OF CONNECTION LENGTH FROM HOU{[[EWER CONNECTING TO Y CURB P L ML TOP L PUBLIC SEWER 0 $T GG ".c. C NO CEPTIC LANK SEEPAGE PIT OR CO PYP MO !OB MO I E PITS ANp/OR GRAINFIELD 0 {1000 PRIVATE {EW ER CON SYSTIMG TO TRUNK PERMIT NO ROAD PERMIT NO C. CO VATC OItPO{AL SYSTEM 0 f]OO O CONNECTOBLDG OR AFFIDAVIT I RMYtR tLtt{tll! RECORT[ u H WORK TO OUSE UB[SEWER D IN{TR NO DA0 f]00 OVERFLOW SEEPAGE PIT GRAINFIELD OC [xTN CESSPOOL DRYWELL 0 SSW JLT O ABANDON HOU{[ HWY OR ST WIDENING (1 SEW ER Oi1ypPOpA1PpYBR}I 0 S]Op V STATE ENCROACHMENT W MANHOLE O $T 00 PERMIT NO 0 INDUSTRIAL h WASTE WA{T[APPROVAL OWNER'S PERM T $ s 00 CHARGES AUMORMATIONJ TOTAL FEE CONNECTION CHARGE FEE 1 HAVE AT THIS DAT[ A CONTRACT WITH THE HEREIN NAM CON REIMBURSEMENT FRI TRACTOR TO CONNECT THE ABOVE G[SCRIpED [ TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS DA 1B_ OWNER OR NEW HOUSE SEWER OWNERS AOCN CONNECT ADDITIONAL A SS BUILDING OR WORK SEPTIC TANK SCEP PITS) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR GRAINFIELD AND STAT[ THAT THE ABOVE IS CORRECT AND AOR[[ TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ ORYW[LL [I I HEREBY .4"r" THAT I AM PROPERLY REGISTERED AMO/OR ALTER REPAIR SLW[R OR LICENSED AS WIREDBY LOS ANGLES COUNTY ry0 4TAT[ OF S[WAGC DISPOSAL SYSTEM CALIiOgN1A O AT I AM THE L[OAL OWN OF D INTCHD O RCSIG[ IN TH ABOVE D[{CRIBIO R[tI OE L P PEIRY DISCONNECT RUO AND I ABANDON HOUSE SEWER SIGNATURE \ OF PERMM,.i)=a \ BACKFILL SEPTIC TANKS ❑ SCEP PITISI 5=POOLM VAMIDMm ON ElK M D 1• CASH l_ l 1�ICo 1 2 4 5,1 Fa26 1 0 D 6.00- TB'S43U-GEBOB-Ian APPLICATION FOR PERMIT • COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION OU140ING Aopncee C LOCALITY `rV �G FOR APPLICANT TO FILL IN N[AnEBT RGS{ r EIQb EB aA D¢eDR1 Pr1GN LOT no owMEn LL-�- L 11,tyo ! MAIL Cg {LOCK TRACT ApOq[88 c U NO Oi SIZE OF LOT NOW ON LOT CITY �J TCL NO ��O USE OFO O SUILDINGB DISTRICT NO GROUP MAP SSED By B[ F9 CONTRACTOR E I✓V cz 568 ADORE" tj � CONNECTION DA CITY Q ,�' NO (J O {TAT I pN bo DEPTH , STAT �/ LIC MANHOLE REFERENCE LICENSE NO GLASS /V LOWER NO DESCRIPTION OF WORK Fie TYPE OP co N N[CTIoN LENGTH FROM HOUSE SEWER COMMECTING TO Y CUnB P M L TOP L PUBLIC SEWER 0 fT 00 PC NO SEPTIC IANN SEEPAGE PIT Oq PITS ANO/OR GRAINFIELD 0 {1000 CO IMP NO !Op NO HOU{E SEWER CONNECTING TO TRUNK PERMIT NO� ROAD PERMIT NO 1 PRIVATE DISPOSAL SY¢TEM 0 SS 00 O CONNECT ADDITIONAL BLDG OR AFFIDAVIT I {11VIt• RAI[R[RTR[CO"D IN{TR NO DATE V WORK TO HOUSE SEWER 0 [300 OVERFLOW SEEPAGE PIT GRAINFIELD O [IIT. CESSPOOL DRYWELL 0 85M R ABANDON HOUSE ....IY OR ST WIDENING /, BEW[R ORYNPBBM_�M`STEM $300 Ov STAT-ENCROACHMENTUll W MANHOLE O fT 00 PERMIT NO S INDUSTRIAL WASTE APPROVAL OWNERSCHARDS{ PERNII'I' f ! 00 AUTHORMATION TOTAL PEE O CONNECTION CHARGE FC[ I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT TJIE ABOVE DESCRIBED TING WILLING TO THE PUBLIC S APPROVAIS DATE INSPECTOR S SIGNATURE SIGNED THIS DAY OF IR OWNER OR < NEW HOUBC SEWER OWNERS Ap[ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK AND/OR SEEP PIT({) 1 HEREBY ACKNOWLEDGE THAT I HAVE RE THIS APPLICATION AND/OR ONAINFIELD ANO STATE THAT THE ABOVE I{ CORRECT ANO AOR[[ TO COMPLY WITH ALL COUNTY ORpINANCCB AND STAT[ LAWS REGULATING PLUMBING AND S[WCRp CESSPOOL ❑ DRYWELL 1 HEREBY CERTIFY THAT I AM PROPERLY R[OISTEMKO ANO/OR ALTER REPAIR SCWCROR LICENSED A{ REOUI RED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR T I AM TN[ LEGAL AL OW ER OF AMO [HD TO DISCONNECT PLUG AND R ESIDE IN HE VE D[SCR�BED n[S NTIAL PROPC T ABANDON HOUSE SEWER SIGNATURE OP p[RMRTC BAC KF'LL.¢PTIC TANKS w.Sti[PVPIT ISI P S VAMA1fOy� CK 0 CASH Wo 1 1 6 41.) 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