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Home My Public Portal About10317 OLIVE ST_Sewer__ 3.64 76A643-64 APPLICATI._. N FOR PER IT A�317 6A64 COUNTY OF LOS ANGELES SEW R-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ' - �y JOAN A. LAMBIE, County Engineer ADORE _ d � WILLIAM A. JENSEN. Supt of Building f/,� LOCALITY - NEAREST FOR APPLICANT TO FIL IN CROSS 5T. �l r _ N --LEGAL_.—'--LOT NO DESCRIPTION OWN '4 J „ - MAIL Y-•`.W BLOCK TRACT /_` /F ADDRESS//♦ " - 1''G.{�, .+ NO. OF BLDGS. 1 SIZE OF LO NOW ON LOT CITY e � TEL. -N O. USE OF BW ILD I DISTRICT NO. GROUP I MAP PROCESSED BY PG CONT RAC __ � /j/�;y, c—. ADDREss --L� l CONNECTION CITY TEL. NO. STATION "`'r i# DEPTH _—.. _— UPPER STATE MANHOLE REFERENCE REGISTRATION { tJ COUNTY I 1 r 1� :L' `• . --- NO. DESCRIPTION OF F W WORK FEE _ TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $5,00 P.C.NO. SEPTIC TANK,SEEPAGE PIT ORJOB NO. O PITS AND OR DRAINFIELD @ $10.00 CO.IMP. NO. __ HOUSE SEWER CONNECTING TO �— TRUNK PERMIT NO. ROAD PERMIT NO. U PRIVATE DISPOSAL SYSTEM $3.00 CONNEC_T A—D_DITIONA __—'L BLDG.OR - AFFIDAVIT wAjvr1p EASEMENT RECORD.INSTR.NO. DATE WORK TO HOUSE SEWER $3.00 r O OVERFLOW SEEPAGE PIT,DRAINFIELD _ U EXTN.,CESSPOOL,DRYW ELL.MAN HOLE $5.00 /�� AA TLER,REPAIR ORABANDON HOUSE hPA�T.O •'ID W G C SEWER OR DISPOSAL SYSTEM _� $3.00 .STATE ENCROACHME ' �,r -- PERMIT NO. - -..* 1�" .L`:. '1..' Z ".� ��••• Z r—! -- INDUSTRIAL WASTE APPROVAL — CHARGES OWNERS PERM_IT s! 21 0_0 -- — AUTHORIZATION I TOTAL FEE CONNECTION CHARGE FEE —^^ 'I HAVE AT THIS DATE A CONTRACT WITH THE REIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBE EXISTING DWELLING - fIPPROVALS TO THE PUBLIC SEWER. Lli'i' DATE INSPECTOR'S SIGNATURE SIGNED THIS �,.,� 19_. OWNER OR NEW HOUSE SEWER t OWNERS AGENT CONNECT ADDITIONAL J ,-'� �• S BUILDING OR WORK e ADDRESS_ —= SEPTIC TANK,SEEP,PIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTYORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTiF --CHAT I AM PFj 'Y REGISTERED AND/OR ALTER,REPAIR,SEWER OR ! LICENSED AS R IRGD BY LOS ANd COUNT AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA O AT41 AM THE LEGAL'OW ER , A INTEND TO DISCONNECT PLUG AND RESIDE IN, T VE DESCRIBED ID AL P PERTY. ABANDON HOUSE SEWER SIGNATUR BACKFILL SEPTIC TANKS ❑ ^ OF PER T _ - -- _ PIT(5) ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD - SUPERVISING MECHANICAL ENGINEER CK. M.O. ' CASH s a 7=808 911-57 APPLICATION FOR PERMIT 1 0808 COUNTY OF LOS ANGELES SEWER SEWAGE DISPOSAL. DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING . : w JOHN A. LAIKBIE. County Engineer ADDRESS `r �- CASSATT D. GRIFFIN, Supi of Building LOCALITY FOR APPLICANT TO FILL IN NEAREST cRDSs Sr. LEGAL DESCRIPTION LOT N0, - - OWNER - BLOCK TRACT MAIL e _ ADDRESS NO.OF BLDGS. - SIZE OF LOT.i`;: NOW ON LOT _ CITY :.TEL.NO. USE OF �- BUILOIYGS DISTRICT NO, ''GROUP MAP tBEC PG CONTRACTOP. ADDRFSShr'`:/-. ,,.,-� , ;:,i — CONNECTION DATA — CITY-' TEL, NO. STATION DEPTH STATE -MANHOLE REFERENCE - UPPE'R REGI5TRATFON N0. _ ❑ COUNTY 3V11FR NO. i DESCRIPTION OF WORK TEE HOUSE SEWER CONNECTING TO 1' PUBLIC SEWER _ CSI S 3.50 SEPTIC TANK. SEEPAGE PIT OR TYPE OF CONNECTION - LENGTH FROM - y PITS AND/OR DRAiNF1ELD ;a $3.00 -. CURB P.L. M.L.TO P.L, OVERFLOW SEEPAGE PIT,DRAINFIELD I - EXTN.,MSPOOL,DRYWE'LL,MANHOLE (a? $2.00 __ HOUSE SEWER CONNECTING TO �— P,C.NO. PRIVATE DISPOSAL SYSTEMG> $1.00 CO. imp.P.N0, d06 N0. CONNECT ADDITIONAL.BLDG.OR _ -" -""" - WORK TO HOUSE SEWER Q $1.00 "�'RUNK PERMIT NO. ROAD PERMIT NO. ALTER,REPAIR OR ABANDON HOUSE - SEWER OR DISPOSAL SYSTEM C�' $1,00 STATE ENCROACHMENT PERMIT NO. INDUSTRIAL WASTE APPROVAL _ CHARGES OWNER'S PERMIT $ 11_00 ,ONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE � 9EIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALSDATE �1NSPECTOR'SSIGNATURE TO THE PUBLIC SEWER. -- - .----.— .--�_----_--- SIGNED THIS f� DAY OF " 19 NEW HOUSE SEWER �' CONNECT ADDITIONAL OWNERS AGENT OWNER OR UILDING 6R WORK ---�= ADDRESS. °`- `- .-EPTIC TANK,SEEP, FIT(S) y - --- _' "- -! -- �'-=- A.N�/ORDRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION - AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑ _ WITH AL1, COUNTY ORDINANCES AND STATE LAWS REGULATING -'—� PLUMBING AND SEWERS, ALTER,REPAIR,SEWER O I I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR -SEWAGE DISPOSAL SYSTEM- ----� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND CALIFORNIA OR THAT I AM THE LEGAL, OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL RESID NTIAL PROPERTY. BACKFILL SEPTIC TANKS ❑ SIGNATURECEEP,PIT(S) 11CESSPOOLS FI . OF PERMITTEE VALIDATION ROBERT A. WOOD CK, M.0. CASH--99 SUPERVISING MECHANICAL ENGINEER a