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Home My Public Portal About5530-5538 WELLAND AVE_Sewer__ ZE808 F6A 642 1) APPLICATION FOR PERMI IY2 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING _,--,, JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS • COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEARESTCROSS $'�' LEGAL (PRINT OR TYPE ONLY) DESCRIPTION LOT NO BLOCK TRACT NO. OF BLDG$. SIZE OF LOT NOW ON LOT CITY TEL. N 0. -A/ ID�SIRICT NO.1 GROUP I rLASS I NiAP PROCESSED Y BUILDINGS BK PS k --NTRAC �4- -T DATA CONNECTION ADDRESS CITY t r T.L. No. STATION DEPTH STATE UPPER A/ CLASS. MANHOLE REFERENCE LICENSE NO LIC �h . ---- I. 7N�0 3ESCkIP-ff OF WORK FEE TYPE OF CONNECTIO LENGTH FROM Y CURB P. L 'g cn HOUSE SEWER CONNECTiN67T-0---- M.L.TO P.L. PUBLIC SEWER $5-00 P.C..NO. -SEPTIC-FA4K--SEffK,GE 5/ CO.IMP.No JOB NO, PITS AND/OR DRAINFIELD $io.co _ __-H 0 6 5 E'SEWER CONMECT1NG-TO- TRUNK PERMIT NO. ROAD PERMIT NO, PRIVATE DISPOSAL SYSTEM @ $3.00 Vu _CONNECT AID61TEONAL j5L6d--c;W--------- -AFFIDAVIT WA`IVIV I C;S£-X RECORD-INS 0 WORK TO HOUSE $3.00t 9.T TR.No. DATE OVFRF W SEEPAGE PIT.GRAINFIELD EXTN-,CESSFOOL.DRYWELL.MANHOLE @ $5.00 HWY.OR ST.WIDENING 0 SEWER OR015 - $3. CER NT- STATENE PERMIT NO. LU )NOUSTRIAL V, WASTE APPROVAL z OWNER'S --oo CHARGES AUTHORIZATION TOTAL FEE CONNECTION CHARGE FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR To CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO I H E PUBLIC USLIC SEWER. APPROVALS DATE INSPECTORS SIGNATURE SIGNED THIS--DAY OF-----19— OWNEROR NEW HOUSE SEWER OWNERS AGF NT --------———L CONNECT ADDITIONAL BUILDING OR WORK ADDRESS SEPTIC TA"K,$EEP,PIT(S) I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR OZAINFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES ANO STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL DRYWELL i HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LIC NSED AS REQUIRED By LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM C AL,iFORNIA R THAT I AM THE LEGAL OWNER OF, AND INTEND TO PLUG AN RESIDE IN.. THE ABOVE DESCRI ED RES NTiAL PROPERTY. ABANDON HOUSE SEWER___��/'�/;L SIGNATUREjL OF PERM LSFPTIC TANKS -'7- rTTE;, SEEPBAi.K.PIT El CESSPOOLS C] VALIDATION JACK R. ALLEN SUPERVISING MECHANICAL ENGINEER r(=C KA W O. CASH 'E808 6A 6420 APPLICATION FOR PER=T COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION 51-JILDING ADDRESS JOHN A. LAMBIE. COUNTY ENGINEER COLEMAN W. JENKINS, SUPT. OF BUILDING L LOCALITY ""I L G A D D R E o(::A L NEAREST FOR APPLICANT TO FILL IN CROSS s�r IPRiNT OR TYPE ONLY) D�SCRLP�T LOT-NO. _OWN ER M A I L SLO C K TRACT len L$-, ADDRESS NO. OF BLD GS. '7 SIZE-OF LOT NOW ON LOT CITY TEL. NO..4) USE Q BUILDINGS DISTRICT NO. GROUP I CLASS I SK MAP PR OCE59ED 61 PZ ----"--') cCONTRACTOR , _CONNECTION DATA STATION DEPTH CITY TEL O STATE LIC C _2 I MANHOLE REFERENCE LICENSE L / UPPER -yip - -=W OWER I-LAS. __LA 24 0. DES 'vimPXf&-OF WORK FEE ---__ TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB M.L.TO P PUBLIC SEWER @ $5.00 P.C.NO. SEPTIC TANK.SEEPAGE Pir OR CO. IMP.NO. $1 JOB NO. PITS AND i OR DRAINFIELD 000 CONNECTING To HOUSESEWERCO TRUNK PERMIT NO. ROAD PERMIT NO- PRIVATE DISPOSAL SYSTEM $3,00 0 - ; ` T - - RCONNECT ADDITIONAL BLDG OR FIDAVIT�A.VEff EASEMENT I T . N 0. DATE WORK TO HOUSE SEWER $3.00 OVERFowsEEFA6E i I EXTN.,CESSPOOL.DRYWELL._MANHOLE $5�00 HWY. OR ST.WIDENING 0 A,��ABANDON HbUSV------- S SEWER $3.00 -TATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL z OWNERS PERMdT $ 2 00 CHARGES CONNECTION CHARGE FEE AUTHOMATION TOTAL FEE eev)I-CC) —- —.-- I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT TRACTOR TO CO NNECT THE ABOVE DESCRIBED EXISTING DWELLING To THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS—DAY OF--119— OWNER OR NEW_tnUSE SEWER OWNERS C ONNECT ADDITION AL BUILD I NG OR WOR ADDRESS-_ SEPTIC TANK,SEEP,PIT(S) IHERFOY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND'OTR �OR DRAINFIELD AND STATE THAT T 9 THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCE AND STATE LAWS REGULATING PLUMBING ING AND SEWERS. CESSPOOL 0 DRYW ELL 1HEREBY CERTIFY THAT I AM PROPERLYF REGISTERED ANO/OR ALTER,REPAIR.SEWER R LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE CIS P 0 SAL S STEM *A'iIFORN z A OR THAT � AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. ABANDON HOU SESEWER SIGNATURE 0r PERMITTEE .I.I....-.... SEEP KFPIL]TL(SSEPTIC T ANKS CESSPOOLS VALIDATION JACK R. ALLEN CKV M.0, CASH SUPERVISING MECHANICAL ENGINEER u, E838 2/70 16A 642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL J DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUP T. OF BUILDING OCALITY 7, IL R APPLICANT TO FILL IN cRoss sr: IPRINT o TYPE ONLY) LOT OWNER BLOCK TRACT MAIL c ADDR NO. OF BLOGS. SIZE OF LOT NOW ON CITY-��*,q TEL. No. C USE OF BUILD NGS "ISTR'S- N13K Ap DEPTH P G AOCES-LD il'q U P I LAII " CONTRACTOR P C ADDRESS i z ONECTION DATX CITY C4, j Ale" TEL. NO.?j4l 6 -Z, 3's STATION I STATE L 'c REFERENCE _F MANHOLE LICFN c'-A..est, -c 'z E)Fs RfPTION OF WORK FEE TYPE OF CONNECTION LENGTH F-RO0.S H&UdSEESEWEFd Cix'NTi€C7 NG TO Y. CURB p.L. M.L.TO P.L. pU BL 1C SFWEp S£PP.C.NaL TIC i-ANK,SEEPAG I OR PITS AND/nR DRAN-4iiri-D $ic Co.IMP. NO. JOB-40. - ------ ---- .----------- I'll a,-;J!x HOUSE SOWER CONNECT;PIG TO TRUNK PERMIT PNC. PRIVATE!)!5;POSAL_SYS'E:M ROAD PERMITNO. CONNECT ODI TONAL BLDG.OR AFFIDAVIT WAIVER LAIIIMCN—T ,-WECO-R& TNS�FR.NO-!r DATE 0 WORK TO HOUSE S EWER $3.00 oviRF�-ow---,EEP4,7iE-Prr--DRAINFIELD EXTN CESSPQOL.DRYlVELL MANHOLE $-,.00 Al-TER.REPAIR OR ASANDON-H67ti-S£ HWY, OR ST.WIDENING 0 5 'R OR M NT Ej P WE r DISPOSAL SYSTENI $'i Do T� ME :N7 CE _PERMIT NO. ESd INDUSTRIAL WASTE APPROVAL --'—"'- - -_ ---- i -- CHARGESOVYWER7S7jjRMIT 00 _ I CONNECTION CHARGE FEE AUTHORIZATIONT TOTAL FEE -1-URSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. TRA CTOR T NECT THE AnOVE DESCRIBED EXISTING DWELLANG 0 Co"q TO THE PUBLIC Sr APPROVALS DATE INSPECTOR S SIGNATURE SIGNED THIS -'T OWNER OR NEW HOJSE SEWER 41 OWNERS AGENT CA NNY-CT ADDITIONAL. 0 G BUILDIN 0 R WORK SEPT C TANK,$CEP,PIT( 5-A-P-P 1,,HEREBY A,-.K -X'0Gr. THAT I HAVE. EAC TH! LtCATION AND/OR 1DRAINFIELD At, 5yATr' 'WAT rICE AeWYF IS ANf3 AGRrr To C CIMPLY WITH ALL -01 Wr Y ORDINANCES AND 17ATH LAWS REGULATING 1114 0 AN,' -,�INFRS. CESSPOOL fl URYWELL IJ t HEREBY CERTtI'Y THAY I AM PROPERLY REGISTERED AND/OR ALTER,kEPAIR.SEWER OR L,-E E DISPOSAL SYSTEM IN5 AS REQUIRED BY L OS ANGLES CO)JNlY AND Ei CATE OF SEWAGF -------- RESJDf� IN THE A137 E- DES"CRIBED RESIG!,NT!Al- PROPERTY. CALIFORNIA OR, THAT I AM THE LEGAL OWNER OF. AND INTEND TO -D I iZ ECT CUG AND ABANDON HOUSE SEWER SIGNATURE I BACKFILL SEPTIC TANKS OF PERM SEEP,PIT c 5) I CESSPOOLS _! VALWATION JACK R. ALLEN M.0, CASH SUPERVISING MECHANICAL ENGINEER. J. 'o 2 7" Q' 5 -E808 2/70 16,A 642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS, SUPT. OF BUILDING - "4 / LOCALITY R NEAREST CROSS FOR APPLICANT TO FILL IN . S�� CROSS ST. ONLY,I (PRINT OR TYFF L P''joh! LOT NO, OWNER k�o iS Z PA lz K EGAL D"CR MAIL BLOCK TRACT ADDRESS -Z q r/A,, NO. OF BLDGS- SIZE OF LOT NOW ON LOT CITY5��'A,' 1W1fXljVC- TEL. NO, 01STRiC*CN'0. p"OliTI-A M A P� CEIS�EA SY BUIL,DINGS SS SK pCONTRACTOR f1 "x t'a'd 1 0 R2 Zle & ADDRESScl v CONNECTION DATA CITY TEL NO. ,�/q STArION DEPTH STATE u PPE MANHOLE REFERENCE LICENSE NO. �—Le 4 lzl NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM SEWER0 C ING 0 CURB P M.L.TO PUBL�C SEWER P.L. 714�-E, 0 CO.IMP.NO. JOB RAINrIELD $10.00PITS AND/OR r HOUSE SEWER CONNECTING TO TRUNK PERIA IT NO- ROAD PERMIT NO. PRIVATE DISPOSAL SYSTEM $3.00 t DATE C 0 NN�CT 0 WORK f0 IbEWER $3,00 oveRi�L Ows-E-EFAGIE PIT,DRAINFIELD -E:XTNCESSPOOt'0RYWElL,MANHOLE $5.00 -- -- ---- ------------ ------i HWY. OR ST.WIDENING 0 ALTER.REPAIR OR ABANDON HOUSE _S EWER OR DISPOSAL SYSTEM $3.0 ROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL z F— - - - r—7— CHARGES OWNER'S -$ 0 —4C0NNECTION AUTHORIZATION 7TOTAL FEE IWu I HAVEAT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR To CONNECT THE ABOVE DESCRIBED TO THE PUSL iC SEWER. DATE INSPECT WSSIGNATURE SIGNED THIS DAY OF----_I9__ OWNER OR NEW HOUSE SEWER OWNERS CONNECT ADDITIONAL BU IL DIN G OR WORK _ADDRESS. —------ SEPTIC TANK,SEEP,PIT($) I MERFOY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION ANrl/OR DRAINFIELD AND STA YE THAT THE ABOVE IS _ORoE CT AND AGREE TO COMPLY WITH ALL COUNTYORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEW ERS. CESSPOOL ❑ DRYWELL 1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER, REPAIR,SEWER OR LICENSED AS REQUTEOBY LOS ANGLES COUNTY AND STATE: OF SEWAGEDISPOSAL SYSTEM ALIFORN A OR 71i AT I AM. THE LEGAL OWNER Ov. AND INTEND TO DISCONNECT PLUG AND - RESIDE IN. THE ABOV)EDESCR. JBED RE�S)OENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE — ," __-. OF PERMITTEE ( SA KFILL SEPTIC TANKS =P.PIT rEsspooLS C�l VALIDATION JACK R. ALLEN SUPERVISING MECHANICAL ENGINEER K. M.O. CASH 9c C" D