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Home My Public Portal About5214 SERENO DR_Sewer__ Sam feall ee APPLICATION FOR PERMIT 1 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL Doparmvnt of County Englnew Co=ty of LOS Angeles ADDRDE49 JOHN A LAMBIE COUNTY ENGINEER r„ m CAS8ATTD GRIFFIN SUPT OF BUILDING LOCALITT T ,46-21 FOR APPLICANT i0 FILL IN CRosRs s�TZe LEGAL DESCRIPTION LOT NO OWNER _ MAIL BLOCK61: RACT& S s S � ADDRESS Y SIZE OF LOT ? NOWOONBLOTS _ CITY C,0P,[C �r.rX TEL NO R7—e7vgXl USE OF BUILDINGS ��/ . DISTRICT NO GROUP MAP �e---� BK PG CONTRACTOR ADDRESS CONNECTION DATA CITY NO STATION • 6 DEPTH TEL MANHOLE REFERENCE UPPER ❑ STATE LOWER REGISTRATION NO ❑ COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNE ON LEN FROM PUBLIC SEWER S 9 90 T CURB P L M L 0 P L SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELD ® $3 00 OVERFLOW SEEPAGE PIT DRAINFIELOC RO EXTN CESSPOOL DRYWELL MANHOLE ® !2 00 CO IVP NO NO HOUSE SEWER CONNECTING TO PRIVATE DIS POSAL SYSTEM ® $IOD TRUNK PERMIT NO ROAD ERYIT NO CONNER ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER S 100 PERMIT NO ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL gYSTEY ® 100 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE OWNER'S PMLMT s 1 00 AUTHORIZATION TOTAL F B REIMBURSEMENT FEE EE ' 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLINGI TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THIS DAY Of 19— CONNECT ADDITIONAL 1 ` OWNER OR Xs BUILDING OR WORK OWNERS AGENT - _ -- SEPTICTANK SEEP PIT(S) ADDRE59 ANO/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCON HO PLUGAUSE D CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE H J JOHN A LAMBIE COUNTY ENGINEER VALIDATION, ROBERT A WOOD CHIEF PLBG INSPECTOR CK Y 0 GAPH - I - - 5 3 7 9In FEB 20 4 2.0 0 ::K:3San APPLICATION FOR PERMIT DraWON OF BUUMMG AND SAFM SEWER-SEWAGE DISPOSAL DBp@^I�mmt of CamlT vEa'YBIDDDT �'I m L0 ADY� BUILDADDRESS ING I WM J. FOX.COUNTY ENBmmm CASBATT 10 GRIMM.SUPT OF BUILDING LOCALITT FOR APPLICANT TO FILL IN NEAREST to ST LEGAL Q� DESCRIPTION LOT NO / / OWNER �/♦— .B+IBw TRAC ,$' / V(♦��1 /3 AD PEES NO OF BLDGS Jl I��' L+. SIM OF LOT NOW ON LOT CITY TEL NO V USE OF BUILOING9 DISTRICT NO GROUP YAP CONTRACTOR BK PG ADDRESS CONNECTION DATA CITY TEL NO STATION / DEPTH ❑ STATE MANHOLE REFERENCE/?7 C •� LUPPE REGISTRATION NO 103 COUNTY � ✓ No DESCRIPTION OF WORK FEE 1 HOUSE SEWER CONNECTING TOY TYPE O ECTION LNENGTTOH P FROML PUBLIC SEWER $ S 40 R P L MEN HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL"STEM 1 00 CONNECT ADDITIONAL BLDG ORP C NO WORK TO HOUSE SEWER 1 00 CO INP NO1272 JOB MO ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 100 TRUNK PERMIT NO ROAD PERMIT NO 60 DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DISPOSAL SYSTEM I DO PERMIT NO SEPTIC TANK SEEPAGE PIT OR PITS AND/OR DRAINFIELO 00 INDUSTRIAL CESSPOOL-DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 200 CHARGES 1 00 O{ S p1iT CONNECTION CHARGE FEE S AIIYHOBIZATION TOTAL FEE REIMBURSEMENT FEE IHAVE ED CON. TRACTORTOCONNECT DATE OT E ABOVE WDESCRIBED EXISTING A DWELL NG APPROVALS DATE INSPE TOR 8SIGNATURE TO THE PUBLIC SEWER HOU E SEWER dA4� SINNED THIS DAYqF�19_ NEW ECT ADDITIONAL OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK SEEP FIT($) AND/pR DflA1NF1ELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR SEWER OR PLUMBING AND SEWERS ALTER. REPAIR DISPOHEWER OR I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR EM LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT 1 AY THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL PROPS 7T ♦ SEP FPLL$E CCESSPSOo� LwL L� SIGNATt OF PERM.L. - - WILLIAM J.FOX.CoumTY I-NOINK= VALIDATION R A.WOOD.CHIEF PLBO INBP¢croR LAC0819 1 i�R AUG 3 4 4.50 In 12 54 APPLICATION fOR PERMIT 1 •e9G6DIVISION OF BUMDING AND SAFETY SEWER—SEWAGE DISPOSAL .nE of Coma Engine" ConntT o! Los Angel" 7 / ^L, BUILDING WM J FOX. COUNTY ENGIN[[R p ADDRESS —CASBATT D GRIFFIN BYP'T of BuN.GING LOCALITY FOR APPLICANT TO FILL IN NEAREST / CROSS 5T LE L. DESCRIPTION LOT NO NX SOF / C, OWNER � -ft8woF Gorm, S — 2-r3 MAILEs9 AS / I ^ SIZE OF LOT S.S" NO OF BLDGS NOW ON LOT / CITY L NO aJ/ USE OF Lg BUILDINGS DISTRICT NO GROUP YAP BK CONTRACTOR 16 -c o0h - PC ADDRESS CONNECTION DATA CITY 00�100� TEL NO STATION S O DEPTH a 0 STATE REGISTRATION NO ❑ COUNTY 137,51 N x . YA PER FERENCE TYPE B.SQlINRCTIOH LENQTN FROM / NO DESCRIPTION OF WORK FEE Y CURB P L M L TOP LCaS HOUSE SEWER CONNECTING TOsO PUBLIC SEWER ® S S 90 HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG ON CO IMP NO �� 7 7 JOB NO WORK TO HOUSE SEWER 1 00 ALTER OR RPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 -- TRUNK PERMIT NO ROAD PERMIT NO Z6'1'7S DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT AND/OR DISPOSAL SYSTEM I OO PERMIT MO SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD E 00 INDU9TR'AL CESSPOOL.ORYWELL -- WASTE APPROVAL SPECIAL CONDITIONS ONLY 200 GE CONNECTIOIrcHARGEFEE OvnarS PERM[IT t 1 00 AUTHORIZATION TOTAL FEE 1, SQ REIMBURSEMENT FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN MAN E° CON ��n TRACTOR U CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR SSIGNATURE TO THE PUBLIC RWER L7� SIGNED THIS 8�R AY OF NEW NEW HOUSE SEWER OWNER OR N� CONNECT ADDITIONAL OWNERS AGENTY//VV /fKrL III�fII��f�fLL��lll4��1111 BUILDING D WORK IV SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS ALTER, REPAIR,SEWEROR I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEM LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT 1 AY THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEP C TANKS SEEP PITS CESSPOS SIGNATURE OF PERMITTEE WILLIAM J FOX.CouNTY EmammA VALIDATION BY • DEPUTY UW+ •7S JM vEcJO 44S0- DEPUTY _ O BY BY ® DEPUTY TT