HomeMy Public PortalAbout10634 OLIVE ST_Sewer_11/2/1953_CONNECT ADDTL BLDG TO SEWER DEPARTAC104T OF COUNTY SEWER—SEWAGE DISPOSAL 1110=
,DIVISION OF BMLDING AND SAFETY PERMIT APPLICATION 5
COUNW OF LOS ANGELES
WILLIAM. J. FOX, COUNTY EN13INEER BUILDING
[ADDRESS_.. (j (/j ��• 1 c x
FOR APPLICANT TO FILL IN LocaLITY � I A';-
BUILDING l NEAREST Ir y c-1
ADDRESS ) �. �� - „i}..�I ) CROSS ST. S �—
LOCALITY DISTRICT N0: SERIAL N0: PERMIT N0.
NEAESCROSS ST.)J!`r.�i� P r z C" . !1�3):t17! Il�:1«, or?
i RECEIVED j3Y Ready forinspestiod DATE ISSUED
OWNER f6 ./lit 0A _./��' VC .P ��+"'iftly'�r�4 ��� 7-
MAIL �•
�u USE ZONE ,OCCUPANCY MAP
ADDRESS ,:-J�+,,+ a• BK PG
CITY TE .NO. �)
CONT RACTORCalifarnia Sewer Const.an . CO.IMP.NO.
ADDRESS 1317 Colegrove Ave.., JOB.NO.
CITY Montebello TEL.NCfji1]lOxz ]._.r'fnA TRUNK PERMIT'NO.
REGISTRATIONNO.104445 STATE
St®'fQSUNTY ROAD PERMIT H0.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT NO. PERMIT NO. --
BLOCK _ TRACT INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT "I "ID NO-'OF BLDGs. '
NOW ON LOT CHAd GES
us 'OF `
BUILDINGSi lI/� CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE `
REIM BURSEM ENT'KEE /
HOUSE SEWER CONNECTING TO
PUBLIC SEWER a $ 8.60. /.► RECEIPT NO: DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.ORFCCE TION RECORDED
_ WORK.TO HOUSE SEWER 1.00 t' N0:
ALTER OR REPAIR EXISTING I DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND.ABANDON SEWER
AND/ORDISPOSALSYSTEM 1.00 CONNECTI.O . DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND../OR.DRAINFIELD 2.00STATION -{��7' ��,6 DEPTH
CESSPOOL—ORYWELL
SPECIAL CONDITIONS ONLY 2.00 5. MANHOLE REFERENCE
`! UPPER -LOWER
TYPE OF CONNYGTI014_. LENGTH FROM `� 1
V:- CURB-- [-" P.� M.L.TO P.L. a S
OWNERS PERMIT $: -I• 00
AUTHORIZATION TOTAL FEE I r
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED APPROVALS INSPECTOR'S SIGNATURE DATE
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE,,�PIYALIC SEWER t
SIGNED THI .c— DAY OF.... 19 NEwHousESEWER S� �.� /'
�.__ _.
OWNER. OR BUILDING OR WORK
OWNERS AGENT.. ...__-__-__----• --_.__ . _._..._ _. _.
.�y
SEPTIC!TANK,SEEP.PIT(S)
ADDRESS_�_�. .. ._. _._. .7._. .. AND/ORDRAINFIELD
I HEREBY-ACKNOWLEDGE THAT I HAVE READ.THIS APPLI- . CESSPOOL-0 ORYWELLD
CATION AND STATE THAT THE ABOVE IS CORRECT. AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER..REPAIR,SEWER OR
REGULATING PLUMBING'AND SEWERS. SEWAGE DISPOSAL-.SYSTEM
1 HEREBY CERTIFY THAT IAM PROPERLY REGISTERED. DISCONNECT PLUG AND
AND LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON.HOUSE.SEWER
AND STATE OF'CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE. a SEEP.PIT(S)[] CESSPOOLS[]
r �
OF-PERMITTEE_/.rt
7OA642D 663 1/63 A s