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Home My Public Portal About5329 WELLAND AVE_Sewer__ 76A6420 CE&08 11-57 APPLICATION FOR PERMIT1 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FADD;?FlqG " I®I3I1 A. LAMBYE, County EngineerCASSATT D. GRIFFIN, Supt of Building f FOR APPLICANT TO FILL IN NEAREST _ DESCRIPTION LOT N0, 0O1NE1cam , _ �l } gs t6 ✓ a BLOCK TRACT %, MAIL y Sz ADDRESS_ 1 .. V,i Y�. Le.j`', N0,OF BLDGS. SIZE_OF_LOT NOW ON LOT CITY TFL.NO.- USE OF BUILDINGS �TM; DISTRICT NO.. GROUP MAP CONTRACTOR gid.. - .� �c" _ - ''' `7--a" MBK PG ADDRESS 6 r`, o�^ 1a , , /f y CONN£GTION DATA CITY 1" L j TEL.N0. d a j /t ¢� STATION DEPTH Q STATE `MANHOLE.REFER SCE _ UPPER REGISTRATION NO, H COUNTY L01�+ER NO. DESCRIPTION OF' WORK FEE — HOUSE SEWER CONNECTING TO 46 r'� PU__BLIC SEWER _ @ $3.50 SEPTIC TANK,SEEPAGE PIT OR TYPE OF C6MECT10N LENGTH FROM PITS AND/OR DRAINFIELD @. $3.00 Y. CURk P.L. M.I,.TO P.L. OVERFLOW SEEPAGE Y{T,DRAINf LD PO — EXiN..,CESSOW L,DRYELL,MANHOLE @ $Z.00 HOUSE SEWER CONNECTING TO `1, PRIVATE DiaP05AL SYSTEM >, P.C. N0. _ _ @ $1.00 Y`CO..IMP,NO, JOB NO. CONNECT ADDITIONAL BLDG,OR .;- y. — — �- WORK TO HOUSE SEWER @ $i.00 ,b"c.-„ "�, -"� _,; _ '_RUNK PERMIT NO. A3OAD PERMIT NO, ALTER,REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $1.00 STATE ENCROAC. - ENT PERMIT'NO, iNDUSTRIAI2' WASTE APPROVAL ®— CHARGES OWNERS PERMIT $ l 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE ;f st,f REIMBURSEMENT FEE I HAVE. AT THIS DATE ACONTRACT WITH THE HEREIN NAMEDCON- TRACTORTO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE i1NSPECTOR'SSIGNATURE TO THE: PUBLIC SEWER. SIGNED THIS---,-.—DAY OF r i 9_._ NEW HOUSE SEWER OWNER OR qro CONNECT ADDITIONAL OWNERS AGEI4i [• 1 � � BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP, PIT(S) ANL'/OR DRAINFiELD I HEREBY ACKNOWLEDGE. THAT ! HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _C_ESSPOOL El DRYWELL[I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. ALTER.REPAIR,SEWER OR I HEREBY CER'TIF�� THAT I AM PROPERLY REGISTERED AND/OR SEWAGE DISPOSAL SYSTEM LICENSED AS REQi9IR D BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND .CALIFORNIA OR '(.HAT" .AI AM THE LEGAL OWNER ;.a THE ABOVE ABANDON HOUSE SEWER DESCRIBED R.£ifZBVNTJ� PROPERTY.. J BACKFILL SEPTIC TANKS 0 SIGNATURE,-' � ;= .:.r i afi SEEP.PITS) ❑CESSPOOLS OF Pj; #TTF.E J ' �F VALIDATION ROBERT A. WOOD CK. M.o. CASH � SUPERVISING MECHANICAL,ENGINEER i q v.. iLYf 1 J 4 0 cc", uitr`� � 3. �.. !t 4.0 0 0 `EBD�3_�N 76A642D APPLICATION FOR PERMIT { COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL j4 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FLO-�-: DING JOHN A. LAMSIE, County Engineer ESS WILLIAM A, JENSEN, Supt of guiiding -- ----LiTY Ar OS SST *b FOR APPLICANT TO FILL IN --- -- - - - - -_ - _ --- -- - - - - - -- -- LEGA!_ y y' -- DESCRIPTION LO'f NO OWNER ✓' +, MAIL BLOCK T'fi,'=ty -_ y� .?__ ADDRESS NO. OF BI_DG5. JF' SIZc OF -IDT NOV'i GN LOi S+ C:T'. TEL. ISE C j�jj �r d ' C5(5?RIOT Nth. GROUs' MAP PROCESSED E$Y B'li rL.s aT ° , BKPG COPA ACTOPi ,�/6. ADDRESS , -,j�.+_,L_�,��j_.y + � ,{r /.____ --✓ - '<._____ CONNECTION DATA ^r`- _ ✓ ----__ __--_¢¢ fit__ �p-. __f_- _ TEL. NO.h b'� e. je `ST k'TIC'N J Y PT i .�v` STATE MANHOLE REFECREN E. tlj}�D j REcU 2AT-4N NO... ¢ _ _ L; LOU NTS > P L�LOW R tao. v€SCITlP`T'fON OR` wO FEE --_. --. t __ TY�.PF'OF COP�jNE'C:'f tUM L.EP� ROM _.__ .___._ 'r'-fid">�,"d!/ ! HOUS_.SEWE4 CONNCCTING TO Y _-_ y- F M.L.TO P,L. i LIG.SEWER @ SS100 - -"-^ �-_._ _ ._- - -.-- .._. J R NO- a EP{IC'TANK.SEE AGE FIT Os;. -� � G P;T A^JD Or+i?R 41N IELD IR_• 3 q,Qi1 CO IMP. NO, _- --- - OU E SFNER C'c.aI SIE TING TO TRUNK PERMIT NO. ROAD PERMIT±fy.O ,! �pqf, Prt.IV 1'E L' PO 'A Y5TE'M $3.00 .—• rt—I70" -.N NEf ,��.:T'.ONAI Bt_DU.UR AFFFDAVIT N!NIYxR- €AS4MFNi i REDO RD.;NSTR N{7. DATE t.,Y VOFK TO HOJSE EWER — - - — PIT.GRAINFIELD LXT .,CFS,_-3'OOL OPYWELL,MANHOLE @ $5.00 - 'r_.- .NWT.OR ST.`NID[TdING - , ALT€R.R PAIR 032 ABANDON HOUSE I � M VvEH OR DISPOSAL L SYSY M 53.00 .STATE ENCROACHMENT .- _ _.__. t._..-_. _I--- PERMIT.NO. WASTE APPROVAL t ,_-__--------- CHARGES -___ p� 7�q�g�yy�w -___._ - OVINE l�e..D PERMIT_ _ i 21: 00 GHARG ES AUTHORIZATION� TOTAL -FiE _ _ _ C CONNECTION CHARGE FEE 3 HAVE AT 'PHIS DATE A CONTRACT WIT}f THE HEii E!N NAMED CO. TRA TORTO CONNECT THE ABOVE OESCRIBFD EX7ST'!NG DWELLING ------- �" -- ---t� � - -= TO THE PU BLT_.SEWER, APPROVALS - �N DATE INSPECTOR2 S SIGNATURE SIGNED TH'S--�---DAY OF ------19,- -----------------� _'-I--- -- - OWNER R '1 NEW HOUSE SEWER OWN.RF AGENT'_..- .y - CONNECT ADDITIONAL SUlLOING OR WORK. _.EP11-. A.NK,SEEP,PIT(S3 iHEREBY ACKNOWLEDGE THAT I HAVE READ HIh APPLICATION ANO/ORGR.AIN!•i£.LD I rkNC STATE TUAt T!-!s ABOVE 15 C6RPE:C:T ,AND A,REZE TO ''0MI-LY W'FT..! 4LL f. 'UNTY R:-OiNANCES AND STATE LAWS REGULATING PLUMWNG AND SEWERS. CESSPOOL �_I ORYWELL. Ll i. I HERE By CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER RFPAiR EWER OR LICE"SED RLQU!RED BY LOS ANGL.E_B COUNTY AND STATE Ot SEWAGE DISPOSAL SYSTEM CAL F? N.AJOF2 THAT 1 M THE LEGAL OWNER, OF, AND INTEND TO D!SC O'�tdECT PLUG AND -r RR_,C IN, -*aE ASG'VE OL=-CRI%£:D RFS.U£NT?A)_. PROPERTY. +I ABANDON HOUSE"EWER SIGNATURE. O' PERMITTE:F 'i" +'L- BACKS �L SEPTIC TANKS I� j __._ .._. .._ _ ,"! _.-_ SEC.•,PiT(S) CESSPOOLS VALIDATION ROBERT A. WOOD^ CK. M.O. CASH SUPERVISING MECHANICAL ENGINEER : - t CF80e 3-62 +f/ ✓'�' T2A642D APPLICATION FOR PERMIT r.' COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE, Count} Engineer ADDRESS 'WILLIAM A. JENBEI, Supt of Building �r LOCALITY FOR APPLICANT TO FILL IN (,ROSS $T CESCRIPTIONLOT NO (p.+' OWNER c a+'J�/({ _._ d -¢-f #-y .AIL ^f` BL.O_ K____ TRACT ADDRESS NO. OF BLDG S. Y�{ SIZE OF LOT NOW ON LOT 'aA "TY TEL NO. Ali us. E EI' DISTRICT NO. GROUP MAFPROCESSED BY K --'" PG DD S fiy yv. (/y�� jy� - CONNECTION DATA _ .af-_/167 -I.'Y R.- -. 7 L NO ,,��11yy g SYATi V DEPTH ,� � F�� v - C c, J .rb^ 4 �. -TATE MANHOLE RCFER2 NCI, '' r T ,e -_- 1J r� 14 fwd w �— RGGISTRATIOM NO. � '' j _O-INTY /;/ SLOWER —_— .— -L. Y. _ NO. I DF:SC.RCRTION OF WORK FEE _ TY E O"cfC NNK�r;,rSty I_ENG A FROM � H7U ESE'lV t CONT ECriN 7O1 Y ':' ,-_ UFv�- C qE+i. ML7�XP.L. PUSL.ID'SEWER C. _ ANO! P F; a -_ ., .SHA;J EL.D 'E $10.00 .IMP NO: ✓ j JOB N o. P.T[�" ANf4 F_F FA[F F�7'T c)�7 i i>UuE SE C: ON N F CT 1NO PRS ALE DI �O4 AYS rEFA O"2 @ $3 00 Af`'�p P TRY�IT NOROAD PERMIT W"A{VVR EASEMENT T RECORD,iNb,R K70. DATE T OVERFL CW S`_C-PAGY.PIT.DEAiNFIELD M NHO,_E f& $5:OGAT R, F PAIR O AB N _ _. HWY. OR ST.WIDENING WR P SPO P SYSTEM $..,OO -- r--,_ -. C ROA H T 17 �. WASTE ARPR+�P'L CHARGES OVVI�IER-a PERMIT — -- --- --_ _-_ ref tltl' Y CONNECTION CHARGE.FEL AUTHORIZATION TOTAL FEE -�, '_ -- --- — -- -- ----- ---- - - — --- Y i HAVE AT THIStS DATE A CO NTRAREIMBUR EM NT FEE ,CT WITH THE HEREIN NAMED CON- - - - — -- TRACTOR TO CONNECT TH:E ABOVE DESCRIBED EXISTING DWELLING T'O THE PUBLIC SEWER. APPROVALS DATE. INSPECTOR'S SIGNATURE, 5IGNED'THIS.-- -DA.Y OF------- t9_--- - _. __ _.---- i------- OWNER ORNEW HOUSE SE �y,�j- ,/ WER OWNERS AGEd<T .f' 1 ,/. W"�"�✓` _._._ . -. __. CONNECT ADDf fIONi.L --._—._.___ 13LI IL.DIN OR WORK I ADDRESS— -.. ___ 'EPTI TANK,:IEEE FIT($) I HEREBY ACKNOWLEDGE THAT I HAVE READ PHIS APPI Cq ION AND/OR DRAINF CA AND STATE THAT THE. A13OfE IS CORRECT AND AGR€E TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PL.UMB.:'tG AND.SE'W RS. CE.55 POOL. .7 DRYWF_LL I HEREBY CERTIFY THAT I AM PROPERLY R-E.GIST*:RED AN.O,'O.R ALTER,REPAIR EWER OR I f LICENSED AS RE-OWRED BY [_OS ANGLES COUNTY AND STATE OF SEWA,-E D%SPQ5,,AL SYSTEM I OALIFORN LA.OR THAT I ANT THE LEGAL_ OWNER OF; AND INTEND TO 2..,rat,0'v NE(., PILUG AND --`— RESIDE IN, THE A90YF DESCRIBED RESIDENTIAL PROPERTY. ABANDON HOU-rt SEWER SIGNA,Ll RE SEP TANKS I1 �I_- py OF E.RM?TTEE_.__ 6T �5,afJI'`yy ".�.__...... _—_ c_ESS POOLS VALIDATION ROBERT A. WOOD SUPERVISING MECHAWCAL ENGINEER K. M.O. )'CASH D