HomeMy Public PortalAbout10630 OLIVE ST_Sewer_8/25/1955_CONNECT ADTL BLDG TO HOUSE SEWER eS6D
S& AI�PLICATION FOR PERMIT
S =653 12-5d
DIVISION OF BUMDING AND SAFETY SEWER-SEWAGE DISPOSAL
Depzr:tment of County Engineer
County of Los Angeles anoREs G
WM. J. FOX, COUNTY ENGINEER
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY,� +q`-•�y�:��r ,/�.y �s
FOR APPLLCANT TO FILL IN NEAREST
CROSS
LEGAL -
DESCRIPTION LOT NO. OWNER '., +� ,,-,;;, C ✓_:
BLOCS 17 TRACT /A 2 MAIL d >`
NO.OF BLDG$. -
SIZE OF LOT .: NOW_ON LOT CITY . TEL-. N0. �
USE OF
BJ1LDfNC--._.�_ syr _�' DISTRI Np. GROUP �!AP
BK P
CONTRACTOR ,i' !�. -�..�
ADDRESS Ct911TId1±CTICiIQ DATA
CITY ,�- - f ,` EL. NO. '� jell '" STA7fON DEPTH��
•�-_ STATE MANHOLE REFERENCE
REGISTRATION JNo. /J, C COUNT`' UPPER LOWER
_._.:_.-ice" -__.___�_L_. _
_ TYPE OF CONNECTION LENGTH FPd04t
NO. i DESCRIPTION OF WORK, FEE Y. _CURB P.L. _ M.L.TO P.L.
pr
—� HOUSE SEWER CONNECTING TO ¢Lhr ,,,
PUBLIC SEWER _ tw $ 3.50
HOUSE SEWER CONNECTiNG TO
PRI It D SP05.AL SYSTEM - LOO
CONNECT ADD [TONAL DLDG. OEt �_ CO. 1#P. N0, .30B. 0.
WORK TO HOUSE SEWER 00 - - - ---
A R J� RE Alii Lh1STPly �`-�
SEWER OR D S PV_s l SYSTEM - 1.60 -- TRUNK PERMIT NO, ROAD PERMIT
L J Jit SIL T AND ABANDON SEWER - ,__.__ - STATE ENCROACHMENT',-At!,,,OR D -OEAISYSTEM _ v1.00 1I � _. PERMIT NO.
I 't'JC V u 2'INF 2.00 I_._.�I.-- INDUSTRIAL
i-- -- '� -____ i— - WASTE APPROVAL ..�+
SSPCOI DRYWF LL
_PIAL GUN 1iTIONS ONLY 2.00
PERMITCONNECTION CHAR16E EEE
A aHORIZATION TOTAL FEE � I i ��' 11F:MBURSEIVENT FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED COPi- 1�PI'f�VALS DATE � INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING D- NG
LLI
70 THE P:UBL!C SEWER -
SIGNED THIS DAY CF— 19-- NEW HOUSE SEWER
OWNER OR `` - CONNECT ADDITIONAL
OWNERS AGENT-=- .;-'" >l � BUILDING OR WORK
SEPTIC TANK.SEEP,PIT(S)
AND/OR - 4_1 i£LD �_..
I HIFREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL[j 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND%OR -"-
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND
CALIFORNIA OR -,PAT I AM THE LEGAL OWNER GP THE ABOVE A_EANDON HOUSE SEWER
DESCRIBED RES]OENTIAL PROPERTY. BACKFILL SEPTIC TANKS 0
SEEP.PITS)❑ CESSPOOLS[�
SIGNATURE
OF PERMITTEE
WILLIAM J.FQf)L COUNTY ENGINEM VALIDATION
by by j 4
DEPUTY DEPUTY ,
DEPUTY DEPUTY