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Home My Public Portal About5139 SULTANA AVE_Sewer__ ""° Gu°e a of �/•( APPLICA ION FOR JEI 1 C IINTY OP LOS ANGELES - SEWER-SEWAGE DISPOSAL DEPARTMENT OF COiIN'TY ENGINEER HIID.DING AND SAFETY DIVISION AD LOIIIG ADORES9 O8T JL LN®�. =t Ear TT D 6RTPPDI. 9q1 ei 6mldme LOCALITY FO APPLICANT TO FlU IN NEAREST SS ST A DEBR LOT RO OP. OWNER BLOCK TRACTMAIL ADOBESS 125 F BLD" �y SIZE OF LOT ON ON LOT 17 CITY "L USE OF BUILDINGS DISTRICT M OUP MAP OC Y PG CONTRACTOR � ADDRESS CONNECTION DATA CITY IL DEPTH hl STATEAANliOLfRiFERkMCS .S REGISTRATION N LOUXT No I DESCRIPTION OF WORK FEE PUBLI C SEEWEERCONNECTING TO 3300 TYPE OF CONNECTION LENGTH FRO■ SEPTIC TK SEEPAGE PIT OR T CURB P Y L TO P L PITS AND�1X OR DRAINFIELD E3 00 OVERFLOW SEEPAGE PIT DRAINFIELD N C POOL DRYNELL 00 HOUSE SEWER CONNECTING TO P NO PRIV DI P 1 CO IMP NO JOB NO CONNECT ADDITIONAL BLDG OR TRUNK PERMIT NO ROAD PERMIT NO WORK TO HOUSE SEWER __Aff ' ALTER REPAIR OR ABANDON HOUSESTATE ENLR ,AL SY 100 PERMIT NO INDUSTRIAL WASTE APPROVAL CHARG OWNEWS I PERMIT s CONNECTION C FE8 ADTHOMATION FiOTAL FEE REIMBURSEMENT FEE I HAVE AT DATE A TRACTOR TO THISCONNECTTHE ABOVE DESCRIBED UISTNNGCT WITH THE HEREIAMED DWELLING AMOMS DATE INSP TOR S SIGNATURE TO THE PUBLICS ( � SIGNED THIA OF NEN HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK SEEP PIT(S) AND/OR DRAINFIELD I MEREST ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CESSPOOL El DRYWELL WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER PLUMBING AND SEWERS 1 HEREBT CERTIFY THAT I AN PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEE M LICENSED AS REQUIRED BY LOS ANGELES C AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT AY THE LEG NER OF THE V6 ABANDON HOUSE SEWER DESCRIBED REBID 0 f BACKFILLS C TANKS 77- SIGNATURE 8E PIT S CE POOLS OF PERMITTEE. ®r -- VALID0, ROBERT A WOOD CL L w CM{M SUPERVISING MECHANICAL. BNOINSHR IJ�2 � i52 .nt4221 0D 5_.00 ;� TEMPLE CITY APPLICATION FOR PERMIT COUNTY OF Los ANGELES SEWER-SEWAGE DISPOSAL 1 iDIMSAL MIE;SY�EM@ COUNTY ENC9NEqCO MING SAFETY DIVISIONLDING $perRESS eATI PFDf s t -2 B� ALITY REST =FOR TO FILLSS !T LEGAL OEBCRIPTILOT NER BLOCKTRACL RESS 0 OF SLOGS SIT:M OF LONOW ON LOT TTL NO USE OF BUILD,.:ILDINOB ICT NO GROUP YAP P OCESSED Y BK PG CONTRACT ADDRESS CONNECTIO DATA CITT ElWAG DEPTH HOLE REFERENCE S' REGISTRATO No UUDIP ONR PU BEERCONG TO ]00 SEPTK SEET ORTYPE OF CURBCONNECTIONP L Y L.TOX FROM !; PITSR DRAI ! J .Ll OVERSEEPAGDRAIRFIELD ErTN 9 00 HOUER CONG TO P C NO PRIVATEI TM tIMP NO O JOB NO NOR;TO HOU9EIONALRBLDG OR TRUNK P T NO ROAD PERMIT NO A TER EPAIR OBBREEAABEEANDON HOUSE t ]TATEENCRO ENT POSALSYSTEM PEAYIT NO YN INDUSTRIAL WASTE APPROVAL CHARGES I OWNER'S PEOUTCONNECTION CHARGE FEE AUTHOMATION I TOTAL FFA 0Z0 REIMBURSEMENT FEE I RAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING OWE LIN APPROVALS DATE INlPECT SSIGNATURC TO THE PUBLIC SEW �q SIGNED THIS AY HOUSEADDITIONAL OWNER A BUILDING CONNECT ADDITIONAL OWNERS AGENT- BUILDING OR WORK ADDRE•. BEPTICTANK SEEP PIT(S) AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL DRYWELL WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR !EWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM 1HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUN STATE F DISCONNECTPLUG AND CALIFORNIA OR THAT 1 LM THEGAL OF THE A ABANDON HOUSE SEWER DESCRIBED RESIDENTI OPER BAC;FILLSEPT CTANKS SIGNATURE PIT(S) CEDSPO OF PERYI ®F -- VALIDIATIOROBERT A WOOD R ■ NBUPERYIAHC MNOINEUM iitfo2 6 1 6 Jim 2 2 1 1 0 2 5.0 0 7. � V U Cit"s6 APPLICATION FO PERMIT 1 a.o.. .. CODN" OF LOS ANGELES DEPAMUM of COUM ENGUIUM SEWER—SESAL WAGE DISPO HUUMMG AND SAFETY DIVISION BUI LDIxG JD®!A. LAM M CemtT awhww . CASRILST 1) GEOFFM. Wt of BRDiW LOCALITY TAmpla City "AN' F OR FILL c[oBB BY sereno DESCRIPTION LOT NO OY 2 OWNER n, 'W EhriRman TRACT f -/,t-/ M" 1 Sultana NO OF LOT NOW ON LOTS /� CIT V TEL NO NGS DISTRICT N GROUP YAP P K PG CTOR V1.C6 U MaxBon Rd. DATA TEL NOGI 2020 OR DEPTN MANHOLE REFERENRATION MO COUNTY gE R 10R FEE OICK}SAEMEERgCgOENNEpCgTING TO SS00 ETS AND/OP DRAINF'IELDTOR S� 160F CONNECTION LENOTo FRON T CURB P L Y L TOP L VERFLOW SEEPAGE PR DRAIMFIELDMN CESSPOOL ORTW!?LL MANHOLE S00 MOUSE SEWER CONNECTINGTO PCNOPRIVATE DISPOSAL STSTE■ 1 00 CO IMP NO JOB NOCONNECT ADDITIONAL BLDG OR 7➢UN6 PERNIT NO PERMIT NO ��O��R��KppTOp�H0 SE SppF//W�lAAR pppp 100EWFJI OR DIlMSALBSTSTEY tl0U3[ 100 PERMIT NOSTATE ROA INDU IAL A APPROVAL CHARGES OWNEH�S �T Y 0 CONNECTION CHARGE FEE AUTHOEMAnON TOTAL FEE REIMBURSEMENT FEE I RAVE AT THIS DATE A CONTRACT WITH THE HEREIN qAM® CON APPROVALS DATE I PECioa S SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER SIGNED THIS DAY OF Ili_ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGER BUILDING OR WORK BW SLRIC TANK SEEP PIT(S) ADDRreR ARD /OR DRAINFlELO I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL DRTWELL WITH ALL COUNT ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWER OR PLUMBING AND SEWERS on DISPOSAL SYSTEM 1 HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BT LOS ANGELES COU AND STATE OF ABANDON HOUSE SEWER CAl1FORNIA OR THAT 1 AN THE LEGAL OWN 0! TYE ABOV[ DESCRIBED RESIDENTIAL P�OPBHTT. BACKFILL C TANKS❑ SIGNATURE SEE PIT CESSP00 OF PERYI mr ATION ROBERT A W0015 AS ■ R GASH SUE4XIMSING MECHANICAL NNGINNMR �tT�o27932 JUN 27100 5.00 - e [. APPLICATION FOR RMIT coum" or Los ANGELES SEWER—SEWAGE DISPOSAL 1 DWAHTI,N! OF COUM ENGDOM t BOBMING AND SAFETY MWON Rtl euILDlxa _ TORN A. Lm ComtY amhww ADDRESS 5139 N- Sultana CASSATI!D O18117M, BRp'1 of Building LOCALITY NEAREST FOR APPLICANT TO CRO3S BY IN - DESCRRIPTION LOT No Y 0 oWNER D q Eh imm$n J BLOCK TRACTAm NO OF SLOGS SIZE OF LOT NON ON LOT CRT T• C TEL NO USE OF - I BUILDINGS RBH• T3TATZEI.Ho GROUP YAP PROC BT BK PO CONTRACTORare a ADDRESS 2933 Maxson Rd. CO ON DATA cm Dl Monte TEL No GI .. 0DEPrHFERENCE PPfiRIGISTRATIOR RO NO D RI I OF ga FEEHOUSES ER CONNECTING TOyyP��UBLIC}}S((E�WER rg S 00PR9 AND/OR USE NFIEIDT OR S CONNECTION LENGTH ROYCURB PLYL TOPEOVERFLOW SEEPAGE PIT DRAI NFIELDERNCESSPOOL D TW LLMANHOLE Y 00HOUSE SEWER CONNECTING TO`PCRIVATE DISPOSAL SYSTEM 1 00 bbJ BNO WO��R�IR(TOp HppOUSE 6NAL BLDG OR 1 00 R MO ROAD PERMIT NO SEWER OR D ISPORAL SYSTEN NOOSE 100 HERMIT ENCROACHMENT No IND IAL WASTE APPROVAL CHARGES TE 0�M'S PEUCT CONVECTION CHARGE FEE AUTHOHTLATION TOTAL FEE 47-9 REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVAL$ DATE INSPECTOR 981GNATUR6 TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DIYELLING TO THE PUBLIC SEWER SIGNED THIS SAY OF 1B_ NEW HOUSE SEWER OWHIR OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK NewSEPTIC TANK BEEP,PIT(S) ADORE' AND/OR GRAINFIELD 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY CESSPOOL ORTWELL WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR,SEWER OR PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROMLT REGISTERED APD/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT 1 AM THE LEGAL ON Of THE ABOVE DESCRIBED RESIDENTIAL OP BACKFILL SE IC TANKS❑ SIGNATURE PITS CESSPo OF PERYR mr 1ATION ROBERT MECHANICAL WOOD - C[ ■ 0 tltS MUPBRVIMINO MEC}IANIC:AL YNOINBMR Lilf,02 7 9 4 5 JUN 27 1 1 0 2 5.0 O n