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Home My Public Portal About9434 WOODRUFF AVE_Sewer__ E80.3-62APPLICATION FOR PERMIT t COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION eu;LolNc + JOHN A. LAMBIE, COUNTY ENGINEER AooRE55 COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY NEAREST FOR APPLICANT TO FILL IN I,;.OS S 5T. < _ LEGAL -__.__—_ S _ - _ - - DESGRIPTION 51- LOT NO. ,N1 f.r.,�ij. j„� E;.'-` OWNER _ i� 4214 MAIL BLOCK _ TRACT -I✓ ADDRESS__ NO. OF BLDG5. r SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF BUILD NG$ DISTRICT NO. GROUP MAP PROCESSED BY _ BK CONTRACT_. ....-./ ,4.,s* ADDRESS CONNECTION DATA CITY STATION / i- DEPTHt{ L. NO. j f� 'STATE 17 LIC �p7 '�y. MANHOLE REFERENCE y�p' j,.'. LICENSE NO; _SL/—CJ CLASS rK/ f ✓_F ,' ;§'`'-^ LOWER NO.+H .DES RIPTION OF WORK FEETYPE OF C�,4NNECTION LENGTH FR M q - OUSE SEWER CONNECTING TO AR Y. f"Y CURB P;L. M.L.TO P. ,J� CL I PUBLIC SEWER @ $5.00 I SEPTIC TANK SEEPAGE PIT OR .ej 6 P.C.NO. PITS AND/OR DRAINFIELD @ $10.0 CO.IMP.NO. / y .JOB NO. HOUSE CONNECTING TO t— f� "7 TRUNK PERMIT NO. ROAD PERMIT NO, 7 _PRIVATE DISPOSAL SYSTEM @ $3.00 - / CONNECT ADDITIONAL.BLDG OR AFFIDAVITWAIVER 'EASEMENT RECORD.INSTR.NO. DATE WORK TO HOUSE SEWER _ @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD - I t 1 E%T N.:CESSPOOL.QRXWELL.MAN HOLE @ $5.00 a- _._.r.—_.—__._.—._—A ——N HOUSE HWY. OR ST.WIDENING � ALTER.REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM $3.00 ------- - - - _j—_ � _--L-- — STATE ENCROACHMENT 1 —_— -----� I PERMIT NO. — -- INDUSTRIAL WASTE APPROVAL O YY IYLR,�7 _PERMI�• 21 00 _— _CHARGES -_fi--- CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE ! ---- IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN fAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE.ABOVE DESCRIBED EXISTING DWELLING -- ---- TO THE PUSLtC SEWER, APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THISDAY OF 19_ OWNER GEN �� NEW HOUSE SEWER A OWNERS AGENT �v�-; - -------- CONNECT ADDITIONAL BUILDING OR WORK ADDRESS____ SEPTIC TANK.SEEP.PIT(S) 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY -------- WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑. DRYWELL Q - HEREBY CERTIFY THAT IAM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF S EWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN. THE ABOVE D RIBED RESIDE AL PROP E TY. ABANDON HOUSE SEWER SIGNATURE f -- ----�--- OF PERMTTT �. BACKFILLT9wE-#A#.T?F3"I� _ _ Zt SEEP�iR fe4'.fif`,..., QI1. CES I* JACK R. ALLEN I SUPERVISING MECHANICAL ENGINEER CK W O. CASH D 7.0 -0'_ v '1 f E6°63.62 APPLICATION FOR PERMIT 6A642D COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING �f o JOHN A. LAMBIE. COUNTY ENGINEER ADDRESS COLEMAN W. JENKINS. SUPT. OF BUILDING ^� LOCALITY NEAREST �y FOR AP_�Pr; TO FILLS N — —CROSS ST. Al LEGA L----_—LOT E �M/ �'P"/ OWNR �— t DESC R.fPTfON `� � •� ! MAIL BLOCK TRACT ADDRESS —_ NO. OF BLDGS. SIZE OF LOT NOW ON LOT - CITY T.L. N USE OF -- ,:L T- DISTRICT NO. GROUP MAP PROCESSED BY BUILDINGS /J�f" /BK CONT RACTOR1� G' f� ADDRESS - ,� _ CONNECTION DATA - CITY TEL. NO. �� STATION —. -.J � DEPTH S STATE LIC LICENSE NO, GL ASS �'°°" ,.�—p MANHOLE REFERENCE C LOWE a NO j DESCRiprrION OF WORK' FEE TYPE OFC j10 LENGTH g Orn HOUSE SEWER CONNECTING TO Y. CUR P.L. M.L. 70 L. CL I PUBLIC SEWER @ $5.00 P.C,NO. 0 SEPTIC TANK,SEEPAGE PIT OR CO.IMA, NO. PITS ANDi OR DRAINFIELD @ $10.00 ` � JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT NO. ROAD PERMIT N +y PRIVATE DISPOSAL.SYSTEM __@ $3,00 CONNECT ADDITIONAL BLDG OR AFFIDAVIT IrWAIVED EASEMExT RECORD.iNSTR.NO. DATE M' }WORK TO HOUSE SEWER $3.00 `V OVERFLOW SEEPAGE EXTN..CESSPOOL,DRYWELL.MANHOLE @ $5.00 HWY.OR ST.WIDENING Y— Rp) -- —,REPAIR OR ABA-- -- --- H---U— — SE -- — -- ALTER,RNDO NOI _ `-1 d SEWER OR DISPOSAL SYSTEM @ $3.00---ttt--- _ _ STATE ENCROACN MENT .ry I __. _— PERMIT NOf�, Ci �.. --- ------*--'— INDUSTRIAL _r-_---- 1 WASTE APPROVAL 1' OWNER'S PERMIT 5 00 - - ^CHARGES CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE — — I. HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING --- -' ---- TO THE PUBLIC SEWER. APPROVALS DATE INSP'ECTOR'S SIGNATURE SIGNED THIS-DAY OF 19_ -- ------ OWNER OR NEW HOUSE SEWER OWNERS AGENT_. CONNECT ADDITIONAL p ,y ADDRESS__-_ BUILDING OR WORK ''� 4' -d SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR GRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ----.-- -- — WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ ! HEREBY CERTIFY THAT i. AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LIC ENSEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT i AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ROVE DES IBED RESIDENTI L PROPERT - ABANDON HOUSE SEWER SIGNATURE OF PE.RMTTTE . lam BACKFILL SEPTIC TANKS ❑ SEEP,.PIT(S) ❑ CESSPOOLS ❑ ^ VALIDATION JACK R. ALLEN 1 SUPERVISING MECHANICAL ENGINEER CK. M.O. CASH �s'