HomeMy Public PortalAbout10249 OLIVE ST_Sewer__ A. DEPART ZNT OF COUNTY ENGINEER SEWER-SEWAGE -DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
N COUNTY OF LOS ANGELES - l�
0 WILLIAM J. FOX, CDLJNTY ENGINEER BUILDING ✓ [r�'Y
AQDRE88 !C `e,r
l i' t Z..� .-.C:►�_. "SSI.
FOR APPLICANT TO F LL IN
LOCALITY
;
BUILDING ,y. ,,��yy capes sT. - 1 t t r- k.
ADD /� j+: L 1
LOCALITY `� DISTRICT N0. SERIAL N0. PERMIT N0.
NEAREST, /� � /� _/� J A I D S
CROSS 37. ItFCAjVED BY Ready for Inspeoflon DATE ISSUED
OWNER TAA
MAIL USEZONE OCCUPANCYBK MAP PG
CITY TELAO.V 1A J �
CONTRACTOR..., cornis segoer const-Go- CO.IMP.NO. / 9
ADDRESS ry colegrove .Ave. JOB.NO.
CITY M_., tebelIG TEL.NOi1Ni on 1-5048 TRUNK PERMIT NO.
STATE
REGISTRATION N0: b04 AR S'�•CI$INTY ,ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT NO. J /•/J ii1 LD Y k- LJ PERMIT N0.
BLOCK TRACT /Lf; L¢/ WASTE APPROVAL
SIZE OF LOT k /.fL/) NOO'.OF BLDGS. l
NW ON LOT CHARGES
USE
BUILDINGS: n JQ__4 CONNECTION CHARGE PEE /
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
J PUBLICSEWER a $ 3.50 (J RECEIPT N0. �I� ATE I BY
HOUSE.SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER •I:OD
ALTER OR REPAIR EXISTING N0. I / DATE 16y
SEWER OR DISPOSAL SYSTEM 1.00 \
DISCONNECT AND ABANDON.SEWER
AND/OR DISPOSAL SYSTEM 1.00 COIfNECT10N DATA
SEPTIC TANK,SEEPAGE PIT OR +
PIT8.AND/OR:DRAINFIELD 2.00 ;STATION.f-- �, DEPTH
CESSPOOL-D RY W ELL
SPECIAL CONDITIONS ONLY 2.001 MANHOLE REFERENCE
.,E J UPPER IJQ_y
TYPE OF CONNECTYO -+, LENGTH FROM
OWNERS PERMIT $ + •1 00 �X" OUR P.Li M.L.TO P.L.
AUTHORIZATION I TOTAL FEE v
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR.TO CONNECT THE ABOVE DESCRIBED-EXISTING APPROVALS INSPECTOR'S SIGNATURE ' 'DATE
DWELLING TO THEPU LIC SEWER
SIGNED THIS ,!"'DAY OF.. _ 19 NEW'HOUSESEWER Sg>A G :' � �
OWNER OR f BUILDING OR WORKNECT
OWNERS AGENfto!
� . .:.. . . _....._ SEP-TIC TAN
ADDRESS._Ir. :'�'�. .._... AND/OR'DRAINIELDIT(S)
_..........s. . ....:........1.HEREBY-ACGE THAT.1 HAVE READ THIS APPLI- CESSPOOL E] DRYWELL❑
CATION'AND STATE THAT THE ABOVE 18 CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE'LAWS ALTER,REPAIR.SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE REPAIR,
SEWER OR
I HEREBY CERTIFY THAT ! AM PROPERLY- REGISTERED SEWAGE
DISCONDISECT PSAI AND
ANEM
D/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE.8EWER
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED R SIOENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑
❑ er hY0 k ff-o- :u
SIGNATURE �,�// SEEP.PIT(S) CESSPOOLS S�`i 6
OF PERMITTE:J" J_. _ - •--•-_..-•-._.:_...+ . __.....
76A642D 663 1/53 A1, _,