HomeMy Public PortalAbout10308 OLIVE ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER ' _zlMWER--SEWAGE DISPOSAL
&VISION OF BUILDING AND SAFETY ' PERMIT APPLICATION
COUNTY-OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER I BUILDNG
ADDRESS c)3® a lz:t
/FOR APPLICANT TO FILL IN LOCALITY i BILD
NEAREST
ADD EISS CROSS ST. t
LOCALITYy DISTRICT NO. SERIAL N0: PERMIT NO.
CROSS 8T. /���C�a ' A e In, saes
CEIVED BY Ready for Inspeotian DATE SSUED
OWNER z•. P�/n �
ADDRESS _` EJ• .+ 49 L-L f.'I"«� pI USE 20 ' OCCUPANCY BK AP PG
CITY : L G.•F1�Z EL.NO. (J� �` �i `/ A—1 I I
CONTRACTORAl A�Cy�vy C�� CO.IMP.NO. zstj ® °�(
ADDRESS Tom)( / e/—G L.�' JOB.N0.
CITY TELAO. #OCP r SII.. TRUNK PERMIT NO.
Cr'gT—ATE
REGISTRATION NO. COUNTY ROAD PERMIT NO.
LEGALSTATE ENCROACHMENT
DESCRIPTION LOT NO. x Fif d") PERMIT NO.
BLOCK TRACT./ �` INDUSTRIAL
WASTE APPROVAL of d
SIZE OF LOTNO.Oi NOW ON LOTS CHARGES. I
USE OF
BUILDINGS CONNECTIO ARGE FEE
NO. DESCRIPTION OF WORK FEE
REIMBURSEMENT F
HOUSE SEWER CONNECTING TO
PUBLICSEWER 0 $ 3.50 RECEIPT NO. DATE IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL.BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- I DATE - BY
SEWER OR DISPOSAL SYSTEM 1.00 /
DISCONNECT.AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR R
PITS AND/OR DRAINFIELD 2.00 STATION �� V DEPTH
CESSPOOL—ORYWELL 1 MANtlOLE REFERENCE
SPECIAL CONDITIONS ONLY 2.00 ®•
6 O CUPPE
TYPE,OF CONNECTIp LENGTH FROM
OWNERS PERMIT $ I I 00 . - "CUP'r P.L.A` M.L.TO P.L.
AUTHORIZATION TOTAL FEE
i HAVE THIS DATE CONTRACTED WITH'THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING: APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO-THE PUBLIC SEWER
SIGNED THIS_ _DAY OF. �' Ig =1�7 NEW NOOSE SEWER 9G17YO
OWNER OR , � CONNECT ADDITIONAL
OWNERS AGENT._`* , .f� 'y
SEPTIC TANK,SEEP.PIT(S)
ADDRESS..._ : E �. ._3:f��J�:t c- _. w_ .l AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL Ij DRYWELL
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 CERTIF. THAT I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND LICENSED REQUIRED BY LOS ANGELES COUNTY= ABANDON HOUSE-SEWER
AND STATE OF CAI.j NIA OR THAT 1 AM THE.LEGAL OWN-{
ER OF THE A601[ D CRIBED RES ENTI L PROPE BACKFILL SEPTIC TANKS E]
SIGNATURE -SEEP.PIT(S)[] CESSPOOLS
OF PERMITTEE----..:
70A642A 663 7/53 �1�
DEPARTBI '" of aouww ENGHNEEIi SEWER—SEWAGE DISPOSAL .
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION �-®34 1
C0UIM OF LOS ANGELES
WILLIAM J. FOX, COUNTY .ENGINEER BUILDING
s ADDRESS ,'` •' .,.t`• L, �. �• L �.
Ir FOR APPLICANT TQ FILL IN LOCALITY
BUILDING / q� NEAREST �✓' r ` "�'
ADDRESS Zb P, /_/ CROSS ST. L_L}t.tt_ C?•( ��__ ,�-
LOCALITY 0 DISTRICT NO. SERIAL NO. PERMIT NO..
CROSS ST. ry phi f], J
RECEIVED.BY Ready for Inspection DATE ISSUED
OWNER I f•: ti� t, -�,:t. J(` / a' �
MAIL USE ZONE OCCUPANCY MAP
• ADDRE8S . ;- BK PO
CITY TELAO.
CONTRACTOR' California Server COnmt. a— ,CO.IMP:NO.. I ClyV
ADDRESS 1317 Colegrove Ay$- JOB.NQ.
CITY Montebello TELAO.UNit., TRUNK-PERMIT NO.
REGISTRATION NO. 10444.5 S IES� ANTY ROAD PERMIT AO.
LEGAL. // +� STATE ENCROACHMENT
DESCRIPTION LOT NO. PERMIT N0.
BLOCK TRACT� INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT x '/4 NOW ON LOTS CHARGESUSE f t
4
ll
BUILDINGS CONNECTION CHARGE FEE A
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO v REIMBURSEMENT FEE
PUBLICSEWER OI S '3.50 RECEIPT NO.
HOUSE SEWER CONNECTING TO .,
PRIVATE DISPOSAL SYSTEM l.00 �
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORdED If', �'
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- I DATE I BY\ t,r
SEWER OR DISPOSAL SYSTEM 1.00 AF,
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM .1.00 . CONNECTION DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/ORDRAINFIELD 2.00 STATION # �j �. Fj DEPTH /
CESSPOOL—DRYWELL _.
SPECIAL.CONDITIONS ONLY 2.00 . /L7 t1ANHOLE REFERENCE
I �-)b, UPPER �R -
TYPE OF CONNECTION LENGTH.FROM.
7—
OWNERS PERMIT_ $ I 1 CURB P,Lc.00 M.L.TO P.L.
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE D SCRIBED EXISTING APPROVALS INSPECT.OR'SSIGNAT � DATE
DWELLING TO THE PLIC SEWE
SIGNED THI NEW HOUSE SEWER ✓
S _..J.DAY OF --.-- .---_....__.......19� I
OWNER OR ./
CONNECT ADDITIONAL
OWNERS AGENT .�', _ .... �. ....: .... ........._ BUILDING OR WORK
Ct. - SEPTIC TANK.SEEP.PITS)
ADDRESS_. AND/OR DRAINFIELD.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL I] DRYWELL 0
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 DISPOSALSYSTEM
I HEREBY CERTIFY THAT. 1. AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS.ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT I-AM THE'..LEGAL OWN-
ER OF THE ABOVE DESED RES ENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)[] CESSPOOLS rl
OF PERMITTEE..
76AG42D 663 1/53