HomeMy Public PortalAbout4931-4933-4935 SERENO DR_Sewer__ DEPARTMINEE
ENT OF COUNTY ENGR 'SEWER—SEWAGE DISPOSAL
DIVISION OF BUELDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING c
CABBATT D BRIFIIN Bund ov BUILDING
ADDRESS 1 �7
FO)lt APPPUCANT(/�T,OO RLL
LIIN� LDCALITr �A.BUILDI , r�
AD HERB
cJ EY/Ge,VI.O CRROSS ST I J
LOCALITY / —pJ AA�a c ., 7A{ DISTRICT NO SERIAL NO PERMIT NO
CERO888T .nrC/N/ TIT CA-S A ��Q � 5
��6A&,fi �� RECEIVED Ready tarl0e0aalio0 DATEISWED
OWNER �Q t/("4a /. a -• - (�
ADDRESS 4 7 ���E�J U8E 2ONEN 0C/C/U�P9t,4-
CONTRACTOR
A�N�C,Y �I' BK M�PB
CITY T• TEL NO�. �*I 41 e� V 9t,`�
CONTRACTOR &9_07-/ ,y 4kVd/C CHARGER REI BUMSEMENTFEE
ADDRESS A— 4v0 J-W;44, REQUIRED -
CITY t4lQCiD 14- TEL
NO j/3� NOT REQUI
0 CONNE MOHARGEFEE
REGISTRATION NO 114 4d
I ' STATE
fr.. COUNTY CO IMP MO
LEGAL CA/ J D O-A SV 'is 8fiCE1PT NO DATE BY
DESCRIPTION LOT NO
V O 1L
BLOCK rBAOTOt SY oXLoT aov �� WAIVER FOR REOOR9MOE�—
&ZE OF LOTSD.( Z. ft NO OF BLDGB RECEIPT NO OATB�� 6Y
NOW ON LOT / _
U8E DI 'D �{�
BUILDING6 'Dwed a A/f l/(\��, -7
NO. - OESICRIPTION CF WORK F[[ TRUNKPERMITBO ' '
HUBOUBESELICSEM'1Y
[RCONNECTING
fiRTO @ � 200 ROADPERMITNO 2, J
P
ROUSE SEWER YY INC TO STATE ENCROACHME j�
PRIVATE DISPOSALSYSTEM 100 PERMIT NO
COMMIECT ADDITIONAL BLDG OR INDUSTRIAL
WORK TO HOUSE SEWER 100 WASTE APPROVAL
ALTER R Rte- EPAIR EX TNG
SEWER OR DISPOSAL SYSTEM 100 CONNECTION_DATA
DISCONNECT ANO ABANDON SEWER
AND/OR DISPOSAL SYSTEM 100 STATION DEPTH, 1p /
SEPTIC TANK.SEEPAIT OR
PITS AND/OR GRAINFIELD 2-00 MANHOLE REFERENC t]_ EGINER'
CE OL-DRYWELL UPPER
SPECIAL CONDITIONS ONLY 200 TYPE OF CONNECTION , LENGtH FROM
CURB ML TOP L
OWNERS PERMIT s 1 00
AUTHORIZATION TOTAL FEE Tl
I 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 )Lor
SIGNED THIS PZ! _ DAY OF 17 19 NEW HOUSE SEWER
4 q
(/�6 CONNECT ADDITIONAL
OWNERS ABERTpG` _ _ ` ` _ _ _ BUILDING OR WORK
ADDRESS 'gl3l - - - AND/OR DRAIMF ELD IT(8) /
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL d DRYWELL e 1 p 01 i
CATION AMO STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STAT[ LAWS ALTER REPAIR SEWER
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED
AND/OR LICENSED AS-REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND
AND STATE OF
CALI IIA OR THAT 1 AM THE LEGAL OWN. ABANDON HOUSE SEWER
ER OF THE ABOVE E RIBED RESIDENTIAL PROPERTY BA K LLE ICTANN -1n
SEEP PIT(S) CE88POOLVO
SIGNATURE
OF PERMITTEE _
TOAS42D 60 12/52 _
TeAL.]D,
cEeoe/eev enol APPLICATION FOR PERMIT r,
_ SEWER - SEWAGE DISPOSAL
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN DISTRICT NO GAWP YAP ' C PPOCESSEO e
EK 2o�'J Pc
BUD.OINO / / z-/ Q� � /
AODR[88 A ' ^ -
`c/rl e CONNECTION DATA
LOCALITY
NRARHT ( T' TATION 3-f/I / DEPTH
CROtI T
/ MANHOLE REFERENCE 3 ' .f�' L W[R
OWNER V Type OF CONNECTION / LENGTH FROM
PAIL 1 �A _ Y CURB PIY MLTOPL
ADDRE
n1 PC NO I. _
'' CO IMP NO r MS NO
CRY / TEL NO :Z 6/e �,
LEGAL TRUNK PERMR NO ROAD PERMR NO
DESCRIPTION LOTNO
AFFIDAVIT WAIVER EASEMENT RHCORD DiBTR NO DAT[
BLOCK TRACT
NO OF
SLOGS
E D$OFLOT 2 NOW ON LOT HWY ORT WIDENING
USB OP
BUILDIHGB STATE ENCROACHMENT
nn ��P AAHRMR NO
CONTRACTOR K/// I C/ I IND
NOU
WATES APPROVAL
ADOR663 �/ / ap 1
CHARGES
///T [L NO p CONNECTION CHARGE FEE
TATA LIC / REGIEURSEMENT FEH
LIC@NEEN CLASS Qi D
No DESCRIPTION OF WORK FE[ ; APPROVALS DATE INSPECTORBEIGNATUR
H W SE SEWER CONNECTING TO
PURLICSEWER
N[W MOUtE SEWeR
WPEODNRNKETCOTNAODSEEPAGE
UDBREIOBPR Ow-
SAAD/OpRAINFIE -
CONNECT
HOUSE SEWER
CONNECTING TO BUILDING W=
A
L
PRIVATE DISPOSAL SYSTEM 31117TIOTANSEEP PIT(S)
I81
CBLDG OR AHD/ORDRAINFIELD
SEWER
OVERPLOW SEEPAGE PR DRAINPIELD CESSPOOL p DRYWELLQ
BETH CESSPOOL DRYW[LL MANHOLE
ALTER REPAIRORABANOON HOUSEIMD/OR
ALTER REPAIR SEWER OR
ttWCR OR DISPOtAL 6YSTEY SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND- - -
ABANDONHOUH[BBWER
BACKFKI SEPTIC TANKSQ - r
OWNER'S Permit SBEEP PTTISI❑ CESSPOOLS
AUTHORIZATION" TOTAL FE VALIDATION mmoomme
I HAVE AT THIS DATE A CONTNACT WITH THE HEREINON
HAVE
TO CONNECT THE AeOV[DE RISED exIST1ING
TO THE PUBLIC EEWE
SK'.NED THIS "DAY OF ���
OWNER OR
ADOI1ee6 �r3 �7 ` `I HEREBY ACKNOYVL[DOQ THAT I HAVE READ THISIONAnoTATE THAT THE ABOVE IS CORRECT AND AGREPLYWRH ALL COUNTY ORDUiANCES AND TATE LAW6INGY1 "'KeyGEP " THATIPROPERLY REGIST /OR • •LIOSNSBO AS REWIREDBY LOS ANGELS COUNTY AOFCIWFORNIAORTHATIAMTHEL[OALOWN[ROP ANDIRB • • • _..
$IDE IN THE ABOVE DESCRIBED RESIDENTIAL W W •
SIGNATURE - /�j�,' .I' _V1 (l1_ • D7 _ .._
OF PERMITTER v CD C 0'
co O O O A _
CH