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Home My Public Portal About5013 SANTA ANITA AVE_Relocation__ :. DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL. r_EDIVI5ION OF BUILDING AND SAFETY 'I PERMIT- APPLICATION - _ COUNTY OF LOS A11TGELLS 'J WILLIAM J. FOX, COUNTY ENGINEER riI' BUILDADDRESS I FOR APPLICANT TO FILL IN LOCALITY C� BUILDING poi �t y ! NEAREST i ADDRESS / ,��,� ;" ® � CROSS ST. � LOCALITY •A1+ �� ?, '� DISTRICT NO. SERIAL N0. PERMIT N0. S CROSS ST . r= / of RE V Y Ready for Inspection DATE�IS..S-U OWNER se MAILi�j _ •AD RESS �'� .� 1� /y� � USE ZONE OCCUPANCY BK MAO PG CITY - AA : )q LNG. ..m m.�— - �_ CONTRACTORAj?tj addileeedl Zee, / 3 S ADDRESS JOB.N0. CITY TEL.NO. TRUNK PERMIT NO. STATE REGISTRATION NO. ® COUNTYi; ROAD PERMIT NO. LEGAL DESCRIPTION LOT N0. STATE ENCROACHMENT,' PERMIT NO. BLOCK TRACT °3 �y `� INDUSTRIAL ' &F WASTE APPROVAL NO.OLOS SIZE OF LOT 4',7 NOW ON LOTS' CHARGES g USE As: /� �a •CONNECTION CHARGE FEE Z 'S- BUILDINGS 9—�. r�" mac__ NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $ 5.50 ! RECENO.�I I BY HOUSE SEWER CONNECTING TO � PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR EXCE ION RCORDED WORK TO HOUSE'SEWER 1.00 -ALTER OR REPAIR EXISTING NO. I DATE I BY SEWER OR DISPOSAL SYSTEM 1.00 ! 'DISCONNECT AND ABANDON SEWER - AND/OR DISPOSAL SYSTEM .•.:i '1:00" C NECTIO ATA SEPTIC TANK,SEEPAGE PIT OR... PITS AND/OR DRAINFIELD- 2.00•=-- STATION - DEPTH CESSPOOL—D RYW E LL SPECIAL-.CONDITIONS-ONLY 2.00 MANHGCNIEFERENCE PER LOWER Y. TYPE OFC N ECTI P.L. LE TO PFR FROM OWNERS PERMIT ; 1 00 AUTHORIZATION TOTAL: FEE - 1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED:, _ CONTRACTOR TO CONNECT THE-ABOVE DESCRIBED EXISTING, APPROVALS INSPECTOR'S SIGNATURE DATE DWELLING TO THE PUBLIC SEWER SIGNED THIS—_MA-Y OF _Iq ONEW HOUSE SEWER` OWNERCONNECT ADDITIONAL OWNERS 'AGENT _ 6 A t,;Ai BUILDING OR WORK ' yyyy -` ` SEPTIC TANK,SEEP.PIT(S) (d ADDRESS._. ...._ _ �__.! AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE.THAT 1 HAVE READ THIS APPLI-; CESSPOOL DRYWELL�� CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FIT.H ALL COUNTY ORDINANCES AND STATE LAWS,; ALTER;REPAIR.-SEWER OR REGULATING PLUMBING.AND SEWERS. SEWAGE DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED " AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY;. DISCONNECT AND ABANDON HOUSE-SEWER PLUG PLUGAND AND STATE OF CALIFORNIA OR THAT I M THE LEGAL OWN-r- ER OF THE ABOVE DESCRIBED RESIDE IAL PROPERTY. s BACKFILLSEPTIC TANKS � SIGNATUREp SEEP.PIT(S)[] CESSPOOLS OFPERMITTEE %.��v,- gJ..F_ :^R_5- .. 7RARA2A RR2 7AR % - DEPARTMENT OF COUNTY ENGXNlI.EIFi SEWER-SEWAGE DISPOSAL DIVISION -OF BUILDING AND. SAFETY • PERMIT APPLICATION COUNTY OF LOS ANGE=S WILLIAM J. FOX; COUNTY ENOIHEERBUI10l,NG ,AdDRESB FOR APPLICANT TO FILL IN LOCALITY 1 e BUILDING0� i,J /1 �� NEAREST ADDRESS A Aj CROSS ST. LOCALITY DISTRICT NO. SERIAL N0. PERMIT N0. NEAREST A �.'�6 -� S GROSS ST. �? / y [�tjE EIVED BY Ready for Inspection- D aAT/E ISSUED OWNER C—LS c� A�rJ�� c r�� !S 11C� �—`(aMAIL ADDRESSJ,.9 A • DV".1-0-c- � USE ZON !� OCCUPANCY BK MAP PO CITY , TEL.NO. ` I f,/ CONTRACTOR 'D +fi�4l••f /J /1.�6�G.�4C��' Oif.==O. ADDRESS JOB.NO. CITY e,4 TEL.NO.be TRUNK PERMIT NO. co REGISTRATION NO. COUNTY ROAD PERMIT NO. a C CL !�5 L ` LEGAL j STATE ENCROACHMENT DESCRIPTION LOT N0. �/ PERMIT NO. BLOCK TRACT l 36_j? WASTE INDUSTRIAL APPROVAL NOW N � 812E OF LOT�J `'1 NO.OF BLDG8: ! CHARGES yyN /O? LOT BUILDINGS ��,wz'Zi141�PT' CONNECTION CHARGE FEE NO. DES izurrI.ON OF WORK FEE RELLW@�lRSEMENT FEE _ HOUSE SEWER CONNECTING TO r PUSLICSEWER @ $ 8.50 RECEIPT DATF.r��'r BY HOUSE SEWER CONNECTING TO _PRIVATE DISPOSAL SYSTEM 1.00 CONNECTADDITIONAL BLDG.OR XGEPTION RECO WORK TO HOUSE SEWER 1.00 Y �� NO. DATE B ALTER OR REPAIR EXISTING. SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON SEWER AND/OR DISPOSAL SYSTEM 1.00 j CONNECTION DATA SEPTIC TANK',SEEPAGE.PIT OR PITS AND/OR DRAINFIELD 2.00 STATION DEPTH CESSPOOL—DRYWELL _ SPECIAL CONDITIONS ONLY 2.00 MAN�H�.O.o�E REFERENCE `rZ..� �CY - •� OW� 1_1 YPE OF CONNECTION LENGTH FROM q Y. ' ,C,''9& 5 M.L.TO P.L. OWNERS PERMIT $ I 00 ,— AUTHORIZATION TOTAL FEE :� I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED ; CONTRACTOR TO CONNECT THE ABOVE DESCRIBED' EXISTING 1 C OR'SSIGNATURE D E DWELLING TO THE PUBLIC SEWER SIGNED THIS__r _.DAY OF._, ��s-_._.._....i9�.� OWNER OR CONNECT ADDITIONAL L- o• OWNERS AGENT. $L..: .�1 ._ ._... BUILDING OR WORK SEiy AND/Olt DNf�E . AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI. CESSPOOL DRYWELL I] CATION AND STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER;REPAIR.SEWER-OR REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM AND/OR LHEREICENSED IAS REQ IRED AT I BYPROPERLY LOS ANGELESISTERED COUNTY DISCONNECT PLUG AND AND STATE OF IFORNIA OR THAT 1 AM THE LEGAL OWN= ABANDON HOUSE-SEWER ER OF THE AB.OV"ESC�ESIDEN IAL PROPERTY. BACKFILL SEPTIC TANKS� SIGNATURE' SEEP.PIT(S)[] CESSPOOLS OF PERMITTEE._ .._ .._•—•--._.._._..___......- ____...._ ::... ......_..... , 79Ae42A rr.8�7/sa f l: