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HomeMy Public PortalAbout10404 OLIVE ST_Sewer__ 0 _ 76AE,66 APPLICATION FOR PERMIT DIVISION OF BUILDING AM SAFM SEWER-SE-WAGE D I S POSA L Department of County Engineer County Of Los Angeles BUILDING ,4DDRESS WM.J. FOX. COUNTY EIv�tNEeIt CASSATT D.GRIF'F'IN, SUP°T OF BUILDING LOCALITY FOR APPLICANT TO FILL IIS NEAREST �y, - LEGAL DESCRlPTiONN . "LG7 NO, OWNER _ ,] ---T N s _ BLOCK TRACT MAIL ADDRESS .. - -�-- NO 17E OF LOT „L o$`p,,. P'04VOONBLGT.'S r¢k.tl .I° r•,-,�� CITY TEL., NO, - USE OF ;,yy BUILDINGS_ DISTRICT NO. GROUP 1 NAP EK PG CONTRACTOR ADDRESS CONNECTION DATA. - , ' TEL. O _ Y `t CITY f , DEPTH STATE, MAtH(1t,€fcFc42EdCE .-- ,UPPER REGI5TRATION NO, LL COUNTY - _ .. - -- TYPE OF CONNECTIQ,N---... LENGTH ERO'If .. NO. DESCRIPTION OF WORK FEE _Y. 4cu�����?.� ��M.L I0 P.L. �-_--- HOUSE SEWER CONNECTING TO . 'Y PUBLiC SEWER_ rz $ 3.50 l a - � — — iPRIVATE DISPOSAL HI _YSTE1.00 ' CONNECT ADDITtOPdAL BLDG. OR CO. IMP.NO JOB. NO. 1 WORK TO HOUSE.SEWER 7.0(7 I _, ;'� Vv u>% ..�_. ALTER OR REPAIR EXIS'IING 5 4i ER OR DISPOSAL SYSTEM1,00 i 1 TRUNK PERMIT NO. ROAD PERMIT NO. —_...-- DISCONNECT AND ABANDON.SEWER STATE ENCROACHMENT tNr/OR DISPOSAL SYSTEM 10.E —.. —�� _ PERMITNO. SEPTIC.TANK,SEEPAGE 2.T OR PITS xltD �s' ORfi1NF1ELD 2 DO 1 IND tRIAL --.-- -_ _. �. la_.._ CESSPOOL DR)'WE L < WASTE APPROVAL SPECIAL Tt NS ONLY 2.00 CONDII � CHARGES _. .._.._— CONNECTION CHARGE FEE OWNER'S PERMIT� $ � t 00 _..__,_--------- J AUTHORIZATION TOTAL FEE i ,,� REIMBURSEMENT Eti7 EE I HAVE THIS DATE CONTRACTED WITH TETE HEREIN NAMED CON= ...... - '.RACTOR To CONNECT . THE ABOVE -..jC4 v D }_)('STING DWELLING - APPROVALS DATE � �.PSF' T'OR'S5 h:4TURi= TO THE PUBLIC Sc.VV`ER NEW HOUSE SEWER SIGNED THIS_._._„�,+:..;__-DAY CF___ ---, _19 _ CINNER 0111 .. ... CONNECT ADDITIONAL OWNERS AGENT.._... "=--^i,i=,.�...�,��,;, t �.,�,,,( _ _BUILDING OR WORK SEPVC TANK, SEEP, PITS) _ANC/ORDRAINFIE:LD F: I HEREBY ACKNOWLE?•GE..THAT I HAVE READ THIS APPLICATION CESSPOOL[] DRY'WrLL E1 AND STATE THAT THE ABOVE 15 CORRECT AND .AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER!,REPAIR,SEWER OR PLUMWNG, AND SEWERS` _ SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROPFRIY REGIISEFRED AND/OR - LICENSED AS REQUIRED BY LOS ANGELES COUNTY .AND STATE OF. DISCONNECT PLUG ANIS - CALIFORNIA OR THAT I AMI THE LEGAL OWNER O.c 'THE ABOVE _ABANDON (HOUSE SEWER _ DESCRIBED RES DENTIAL, BACKFILL.SEPTIC TANKS❑ . SEEP.PIT(S) [I CESSPOOLS - SIGNATURE OF PERMITTE5 WILLIAM J. FOX,COUNTY ENGINEFER VAMATION BY B7 DEPUTY DEPUTY BY BY c DEPUTY d DEPUTY If t' 7EAo43- z 76A642D APPLICATION FOR PERMIT J! - COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL €S DEPARTMENT OF COUNTY .ENGINEER BUILDING AND SAFETY DIVISION BL Lr. hU MIN A. .Agi13TS, County Engineer ---'-- WILLIAM A. 3f3NSEN, Supt of Building y/ LOCALITY Y � 9 NEAREST FOR APPLICAIV O FILL IN R055 T a' _ES OR T10iN l OT'P1f7 OWNER MAI BU''` K TR.4C� P' ADURESS ...�___ y NO, OF 13LOGS.. 'SIZE OF Lui' NOW ON LOT CITY !El-- NO. USE OF B.II I J hCS DISTRICT NO. GT?OLP MAP PROCt SEb BY ?K P FONT RA TOR .t ADDRESS ' ., -,� - CONNECTION 15ATA _ IT_T "' 3 7 TAXON > ro'EP"ti `,. "' REG; , T ATCON NO GC C niT'Y..7�+fd TPoTE MANHOI E R_FERENCE ''l s}.\ "� LJ �LO�WFRR�c NO. T-iUESCR PTbOP 0P YYORK --FEE ---_ ___ .- _.- :EYP O"CONNECTION , _ l LENGTH FROM - I HOUSE S WER CONNE'CT(NG 70 I ✓ Y.C' CURB t M.L O P.P.L. �_. a�iC SFWE:R. � $5.00 ! ..•. i =. , __ -.p_ i £PTIF TANK,SEEPAGE fl17 OR I-'•�. � �-� O. IMP NO. d' 'r `'� � P SJ06 NO, O' PITSSAND/ DRA NF '@ IELO $10.00 I _-_ HOUSESEWER COMNE 7i�iV'G TO - TRUNK PERMIT NO. ROAD PERMIT N&3 -_.- PRIVATE DISPOSAL SYSTEM @ $3.00 ! I Vff E r my NE(,T ADU17'I'ONAL.BLp(;.hR FFIDAVIT WAIVER 6" NF RECORD.INSTR..NO. ---> --A75 As I WORK TO HOUSE SEWER $9:00 1 o% i V RFLOW EPAC,E IT,DRAINFIELD _- FXTN„CL SPOOL DRYWELL V.ANHOLE @ 45..00 HWY.OR ST.WIDENING ` A{,.T E-R,Rc PAIR OF.ASR NDt:J.N HOUSE I —--- --.. SEWER OR DISPOSAL SYSTEM $3.00 - STATE 'NCRO.ACHMENT _..__ 1 PERMIT NC.. INDUSTRIAL `;'WASTE APPROVAL O +e� -..�ERMI� ,� - 2,------ CHARGES } Uta -----.. -._- ----- -- --- ------. - ------ ---- --- CONNECTION CHARGE FEE:AUTHORIZATION yT3wRIZryOq TOTAL FEE - HAVE AT 7HIS DATE A. CONTRACT WITH THE HEREIN NAMED CION- REIMBIRSEMENT FEE TR CIOR 'I”D CONNECT THE ABOVE DESCRIBED EXIST:N6 DWELLfNG �q�9__�_ry�y _g.¢_ T"7 THE '�UBLif SEWER' A.IFTh6V-A,L S C.A E IN'PECTOQ' 5 GNATURF- . SIGNED THIS-_—DAY 0F= .------._ 19-- ---- -- ------ -___I_. _ --¢ _�--_—._.- -- i vW4ER CSR NEW HOUSE E.SEWERONNERS —"--- CONNECT ADDITIONAL ! BUfLD!NG OR WORK ADCrESS - —- ------ — i" ---- rP'r;c TANK,CCEP.FIT;S) HERBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION ANDi OR DftA1NF'ICLC L ! A N L) ,ATE TF4A'( 'C4E. ABOVL'. IS CORRECT AND A.aREE 70 COMPLY" W!,T 11 ALL C V UI�v'i'Y ORDINANCES AND STAREGULA"tING 'PE LAWS ' _I PL MF3!NG AND SEWERS CESSPOOL I,] DRYWELL SHEREFIY CERTIFY 'TRAT I AM PROPERLY REGISTERED .AND/OR ALTER,REPAIR. EWER OR LtCE'NSi_D AS RE-wUIRED BY LOS ANGLES COUNTY AND STATE OF SEW.AGF DISPOSAL SYS'TE'M c'..L ORr IA OR THAT AM 7HE LEGAL OWER OF A.,P INTEND TO DS 'CONNE PLUG AND r?E5[ IN. THE O DESc;f, RE'SL T1,4L 1' OPkJ RTY. F,A§ � - ABANDON HOUSE JSEW ER SIG 1k7':.Rv BA KF LL bE.PT BANKS G)R FERMI j'T'E _ -- — SEEP.PIT(5) [S CESSPOOLS J/ VALIDATION ROBERT A. WOOD /,JC SUPERVISING MECHANICAL, ENGINEER LK,�' M.O. CASH CIS ao B to-ax 75A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BLJILDIN _ 10I-IN A. LAMBIE, County Engineer ADUR_s "_ ct WILLIAM A. JENSEN, Supt of Building LO:ALiTv "!r -- NLAREST FOR APPLICANT TO FILL IN Sr. ---LEGAL DESCRIPTION LO?NO /" OWNER MAIL, _ BLOCK TRACT -; ADDRESSc) _Y ._4`"._�.-,._—..--_.._..___. T4O. OF SLDGS. _ s IZ£: OF LOT NOW ON LOT CITY TEL. NO. USE OF - - BUILDINGS D15TRiCT NO- GROUP MAP PROCESSED BY PG CONTRACTOR ADDRESS CONNECTION DATA --—----- ---- - -_..r --- -- -------. CITY TEL.'NC3,.r STATION DEPTH ❑ `^TATE MANHOLE REFERENCE __UFf'ER__ REGISTRATION NO. - E] COUNTY LOWER No-� G£SCF2IPTIChJ O� WORK Y-EE TYPE a;�'cq�tNc .ioN r .v:.;a>+c7s-t FRPM � � OUS-SEWER COTtNECTING 7O .- -- -- Y - ,. �C<ifRB 6' M.1_ f-3 f t..- tq !..OUSE PUBLIC SEWER - ___ - r� — — t -�. P.C.NO. _-r_-___— 0 $5.40 b — SEP'T`IC 7C NK,SEE Pk GE PIT OR PITS AND/OR DRAIFIELD $10.G0 CO.IMP. NO. IG@ NO N tK aUSE -_SE ___CO__— P.Pd Fc.Ti NG FO TRUNK PERMIT NO. ROAD PERMIT NO, PRIVATE D SPOSAL SYSTEM Lw $9.04 i; CONNECT ADD1TiONAt BLDG OFA/ AFE'IDAVIT wAPxe A.,En§FNT i RE:C G>RD �I V:iTR,NO.T- DATE WORK TO OUSE SEWER @ $3.00 = Uj OVERFLOW SEEPAGE P4T,DRAINEIELD -.• I J �—__— � XTN.,C€S FO01_.LRYWELL,%IAN}ia LE @ $5.00 z l' HW -OR ST.WIDENING ALTER.R PA F2 OF2 At3A NDON HOU.�E_ SEWER O -DIS OSAi_:SYSTEM L $.3.OG I --._.._. _-- _t._ ..____ k.. .-_.__.� .—..__. STATE NCROA6HMENT PERMi-NO. INDUSTRIAL WASTE APPROVAL — OWNER'S + PERMIT � 2' oa -- -- - - -- ---- ._--. CONNECTION C14ARGE FEE. AUTHORIZATION TOTAL FRE t.,Y IHAVE AT THIS DATE. A CONTRACT WITH THE HEREIN NAMED CON. REIM_WPPSEMENT FEE. T NR ACTf_1R TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING --- -- --/-- ------'--?' — ----"' '-'_-- TO THE PUBLIC SEWER. APPROVALj DATE � INSPECTOR'S SIGNATURE. SIGNED THIS_-_DAY ©r•------------SU--- I. �.--.---------.- ._.--- OWNFF{OR NEW HOUSE SE`N E'R OWNERS AGEN'i,— -- _.__ ___—__ --_-- CONNECT ADD;T ONAL I BUILDING OR WORK 1. ADDRESS- SEPTIC DUkE bSEPTIC TANK,SEEP, 17. I HEREBY ACKNOWLEDGE THAT N HAVE. READ THIS A'PPL.ICA71ON AND/OR DRAINFIELD II AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ------- ----.-- - ------ --------.-"----------- N7tTH A 7- %OU MTY DRDINANCES A[vD.STATE LAWS REGUL..A7iNG , PLUM@ING AND SEWERS. CESSPOOL 71 DRYWELL IHE RE%Y CERTIFY THAT . AM PROPERLY REGISTERED AND.AOR ALTER REPAIR,SEWER OR -�—�!---"---"-----�— LICEtd ...D AS RE6 U!RED @YLr75 ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAOWNER OF, AND INTEND T' L O DISCONNECT PUG AND REs7DE !N. 'r,C ABOVE_ DE' CR1BED RESIDENTIAL PROPERt'Y. ABANDONHOU5E SEWER SIGNA URE. O; PERMITTEE �" t T''• . BACKFILL SEPTIC TANKS — �.:., - .. —__—_—_ SE:_4,PET(S) ❑ CESSPOOLS L5 ❑I VALMATION ROBERT A. WOOD r' CK. M-a. CASH SUPERVISING MECHANICAL ENGINEER ;'- 5 ...x