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Home My Public Portal About5607 SANTA ANITA AVE_Sewer__ frt 76A6420 3-54 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FAD ING JOHN A. LAMBIE, County Engineer ESs WILLIAM A. JENSEN, Supt of Building --LITYEST FOR APPLICANT TO FILL IN CROSS 5T. DESCRIPTION LOT NO. _ OWNER MAILixJ BLOCK TRACT ;� — ADDRESS - �.�- NO. OF SLDGS. _y _^�.-r ✓ SIZE OF LOT NOW ON LOT CITY 4{'xi,iJ TEL. NO. USE OF DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS BK PG CONT-RACTOR t - ADDRESS CONNECTION DATA CITY STATION ", 7 DEPTH -'� TEL. NO. '"� I_ -` .r - --- STATE MANHOLE REFERENCE —� UPPER REGISTRATION NO. � COUNTY LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER $8.00 P.C.NO, -_,{.,SEPTIC TANK,SEEPAGE PIT OR _ CO.IMP.NO. JOB NO. D_ PATS AND/OR DRAINFIELD $10,00 O HOUSIE SEWER CONNECTING TO I TRUNK PERMIT NO. ROAD PERMIT NO. (� PRIVATE-DISPOSAL SYSTEM $3.00 j I CONNECT ADDITIONAL BLDG OR .. AFFIDAVIT=ItAscmINT RECORD.INSTR.NO. DATE d' WORK TO HOUSE SEWER _ a $3,00 OVERFLOW SEEPAGE PIT,DRAINFIELD 'EXTN.,CESSPOOL,DRYWELL:MA NHOLE $8.00 - V ALTER,,REPAIROR ABANDON HOUSE HWY,OR 8T.WIDENING 0- d SEWER OR D_lS_POSAL SYSTEM STATE ENCROACHMENT N PERMIT NO. Z INDUSTRIAL WASTE APPROVAL OWNERS _PERMIT $' 2' 00 --- CHARGES , AUTHORIZATION TOTAL FEE � CONNECTION CHARGE 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR T0C ONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLISEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19� OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK i 1 HFRESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SFIFL PITS) AND/OR ORAL NFlELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY - WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN.. THE ABOVE DESCRIBE D RE{SIDENNTTIIyA/LyPROPERTY AS HOUSE SEWER SIGNATURE }Yljl`hS<�t:. „`_ BACKFILL.SEPTIC.TANKS ❑ I OF PERMlT7EE, .�C. — SEEP,PIT(S) ❑ CESSPOOLS ❑ '! VALIDATION ROBERT A. WOOD CK. M.O. CASH m ' � SUPERVISING MECHANICAL ENGINEER ' 2 1 1 5i:2 PAY 2% 8 1 D 2 4 ( .�:� 6A8Q81 6a642o 0-63 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BJI.DIN ✓ i` ADDRESS 4:: .EC)- 'I_'`�-•-� '_`ye``'`.:. JOHN A. LAMBIE, County Engineer -- — --- WILLIAM A. JENSEN, Supt of Buzidfng LOCAL;TY s NEAREST -- - FOR APPLICANT TO FILL IN ARD r LEGflL p F d DESCRIPTION LOT NO _� OVf NER y� if` ga fs a' --.r_ MAIL �yy .. BLOCK - TRACT r t` ---RF 4t �'..✓ "': !Viii _-- 0. OE BLD S. SIZE OF LIT NOW' ON LOT CITYi d 5 ��C; y ? e",✓ TEL. NO. USE OF BUILDINGS IJi-TRIC T NO. GROUP MAP PR 7c�1_$Gf;C7 BY BK PG CONTRA TOR ADDRESS f r, t 1 : CONNECTION DATA CITY TEL, NO.-;;$ �„ ;<. STATION DEP H -- STATE REGISTRATION NO. C3 COUNTY MANHOLEREFERENCE -�� # --IOW— /,- _.. _ _. -P—TI - _ __ __ NO. I GESCRfPTIONOF—WORK PE$ TYPE OF CONNECTION LE`t='TH FROM _ --'THOU E SEWER CONNECTING TC...--- _--� � Y. CURB P.L. - M.L,TO P.L. I ___. �_-_ —___ _.__— .. PUBLIC SEWER C $5.00 -.- ? NO, 1Lt- 5EPTIC TANK,SEEPAGE PfT OR CO.IM r60 JOB NO. - 0 FITS AND OK DRAINFlELD @ $.O.OU �- HJLISF.SF OR rON NEELD TRUN� 11ERPAiT.-N PRIVATE C SPOS.AL.SYSTEM @ CO!N_CT aDJ T OVAL BLDG OR J AF F7DAVIT +r A!vER ens EME wi R=_CORD. INS"k NO ATF WORK TO HOUSE'. OV Ei'fitOW 5.-E 'e PAGE PIT.DAIN FiEL.D E}TN. CESSPOOL,DRYWELL,MANHOLE @ S3.00- -_ HWY.OR ST.WIDENING +` AL ---r'i ,ZO.r.ABA YD ON H'�USE - SEWER'O SYSTEM Cik $3.40 , ,I PERMIT NO, - {--�- --=� ^?- - INDUSTRIAL 3 WASTE APPROVAL OWNER'S PERMIT z 9a .._---- CHARGES # — AUTHORIZATION TOTAL FEE - ? CO[VN£CTIOFI CHARGE FEE'.--_— '1 14AVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTJR TO CON N'C7 TH ABOVE DESCRIBED EXISTING DWELLING --- -+---- -' - '--- - -- TQ THE PUS! C SEVj ;��Y APPROVALS ALR i DATE INSP E;GTOP S SIGNATURE Ti-11.c_ L'7AY` OFuj"?�"_ _- . ___ OWNER OR x NEW HOUSE.SEWER—� OWNERS AGEN?_��-'C.-t-: -- CONNECT ADDITIONAL ADDRESS— BUILDING OR WORK SEPI;C TANK,SEEP.PIT(S) I HERESY A KNOWWLFOCE THAT I r4AVE READ THIS APPLICATION AND/OR DRA.NFIELD AND STATC THAT TH€ ABc.3VE IS CORRECT AND AGREE TO CO MYLY' -.-----:-. WIT'{i ALL.. COUNTY ORDINANC:E:S AND STATE_ LAWS REGULATING PL'J MB!NG AND S='WE RS. Cf 55 POOL j DRYWELL [] i 1 HEREBY- CERTIFY THAT I AM PROPERLY .REGISTERED ANO/OR ALTER REPAIR,SEWER.OR _r I LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE D!SP`JSAL SYSTEM ! IALIFORN IA OR THAT I AM THE EGAL OWNER OF, ! v_------ AND INTENU TO —__— AND RESIDE IN, THE ABOVE DESCRJ5 ES"IDENI'IAL,.P.AOPERTY ABANDiSCOON NF CT PL IC SEWER�`"�. NDON UiiSF SE�h>=R SIGNATURE ""-- BACKFILL EPTIC-TANKS n OF PERMITTEE.. _ 5EEP,PI (.:) r] [� ..ESSPOOLS `VALIDATION ROBERT A. w000 CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER ;sA64zo�` APPLICATION FOR PERMIT'" COUNTY OF LOS ANGELES SEWER—SEWAGE ISPE DISPOSL � DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFFTY DIVISION FOD JOHN A. LAMBIE, Co!nIy Engineer SSWILLIAM A. JENSEN. Supt o! BuildingTYSTFOR APPLICANT TO FIL IN sTl _ — DESCRIPTION LOT NO. ,� "-L-r�-�4,.L1 J<�% OWNER -e'-. y L,S T'fy�.•,.;... G+' .. �- `- MAI L BLOCK TRACT `Y ,,.— ADDRESS '. . -_- NO. OF 8LDGS. _ SITE OF LOT MOW ON LOT „ CITY (.ry ,_�; TEL. NO. USELD NGS //{/� DISTRICT NO. GROUP -MAP. PROCES�FID BY Bs'. PG CONTRACTORY& _ 4_-' .-...s=. 16� d' '.� ." e CONNECTION DATA CITY -TEL. N / .STATION DEPTH e REGISTRATION NO. , Cl COUNTY MANHOLE REFERENCE✓,'; NO. I DESCRIPTION OF WORK FEE '" TYPE OF CONNECTION ✓4 ALENGTH F DM PHOUSE SEWER CONNECTING TO �' Y CURB P L. M.L.TO UBLIC SEWER _� $5.00 I °-` l�SEPTIC TANK,SEEPAGE PIT OR I - .sJ -fit ; P.C.NO. CO. IMP.NO. _"J' /P JOB NO. 0 PITS AND/OR DRAINFIELD � $10.00 ---y-<- HOUSE SEWER CONNECTING TO I ._`'�y'� .� TRUNK PERMIT NP ROAD PERMIT f -c PRIVATE DISPOSAL SYSTEM @ $3.00 ._ .q CONNECT ADDITIONAL BLDG, OR - AFFIDAVIT I WAIVER 11UC.Ex7 ECORO.INSTR.NO, DATE _Y, WORK TO HOUSE SEWER $3.00 ~"r 1.�'('-.; - �"^ - OVERFLOW SEEPAGE PIT DRAINFIELD `-"' ,✓ �,." EXTN CESSPOOL,DRYW ELL,MANHOLE 0 $5.00 ALTER,REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING SEWER OR DISPOSAL SYSTEM @ $3.00 --- "-. F _ STATE ENCROACHMENT y y''�''�.++ > �C f, I•J^ °° � �. _- �_� PERMIT NO. WASTE APPROVAL L �"— CHARGES OWNERS PERMIT i Oo py AUTHORIZATION TOTAL FEE —� c E rfIrGfFEETR ''' P — lltllv 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- RiMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING —' - - TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE O SIGNED THIS DAY OF 19__ OWNER OR Y. NEW HOUSE SEWER OWNERS AGENT /+z-i-- -- - -- CONNECT ADDITIONAL , BU i LDI NG OR WORK ADDRESS_ _ -_-_ -------- SEPTIC TANK;SEEP,PIT(S) 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND 109 ND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE-pESCRI,PE PS RESIDENTIAL PROTY. ABANDON HOUSE SEWER SIGNATURE �' ° / - BACKFILL SEPTIC TANKS ❑� OF PERMITTEE_ ; "-1/ -- SEEP,PIT(S) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD -' CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER Ltj�O 6 3 4 6 OCT 1 1 n 1 CJ.£ N A-174 :E808 A642D�, BP42p APPLICATION FOR PERMIT ' COUNTY OF LOS ANGELES SEWER SEWAGE CISPOSA�. DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DI`iISION BUILDING 5607 Do d e r TL11N A, LAMBIE, County Enggineer ADDRESS' W LIAM A. JENSEN, Supt of Suildiinq_ LOCALITY Temple City NEAREST s FOR APPLICANT TO FILL TN CROSS ST. a ine LEGAL -- DESCRIPTION LOT NO. OWNER BLOCK TRACT '` MAIL ADDRESS NO.OF BLDGS. __ADDRESS SIZE OF LOT NOW ON LOT CITY TEL NO, USE OF BUILDINGS DISTRICT NO, GROUP MAP.te PROC SED BY ��yy BK �'P6. .r CONTRACTOREar - '` Y'aI"e „ rE'F."o ADDRESS Box 408 VECTION DATA CITY E! Monte TEL.NO. 444-77 STATION DEPTH STATE MANHOLE REFERENCE REGISTRATION N0. 1449236 COUNTY OWER NO. I DESCRIPTION OF-WORK FEE - HOUSE SEWER CONNECTING TO -- -, PUBLIC SEWER @ $8.00 5 0 0 TYPE OF CONNECTION LENGTH FR9M SEPTIC TANK,SEEPAGE PIT OR CURB P L: / TD ';Li PITS AND/OR DRAINFIELD $3.00 OVERFLOW SEEPAGE P9T,DRAINFIELD EX'PN,.CESSPOOL DRYWELL @ $2,00 HOUSE SEWER CONNECTING TO .,fl- P• N r` PRIVATE DISPOSAL SYSTEM @ $9.00 C::.--:?�**r- _ J N0 77,CONNECT ADDITIONAL BLDG.OR < I 'a P N0. V WORK TO HOUSE SEWER SI,00 TRUNK PE TN AIH RM1T ALTRqEPAIRR3YNDONHOUSE STATE CROACHMENTlkl 0SEWEIO $1.00 IN STRIAL ;I�Ly I$TE APPROVAL Vy I; 5 P z OWNEWS PERMIT ' 5 2 00 - — AUTHORIZATION TOTAL REIHIBDRUMENT FEE I HAVE AT THIS DATE A CONTRACY VITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE i9ESCRIBED EXISTING SWELLING AT 70 THE PUBLIC SEWER. SIGNED THIS DAY OF— z SIv NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK t ADDRESS - !� SEPTIC TANK,SEEP.PF?(S) AND/OR DRAINFIELD HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPL CATIONi AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL /DRYWELL WITH ALL COUNTY ORDINANCES AND STATE. LAWS REGULATING - ALTER,RJhTAIR,SEWER OR - PLUMBING AND SEWERS. SEWAG:Ir'6i5POSA.L SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER _ CALIFORNIA OR THAT I AM THE LEGAL 0ER OF,, E;;ABOVE rBACKFILL SEPTIC TANKS SIGNATURE +'"� DESCRIBED RES TIAL PROPERTY . � � � v � ,, �/' SEEP.PIT(S Q CESSPOOLS OF PERMITT .`•'. -,�. 'rte AIMATION R09 RT A. WOOD CIL M.o. CASH SUPERVISING MECHANICAL.ENGINEER!