HomeMy Public PortalAbout10525 OLIVE ST_Sewer__ APPLICATION FOR PERMIT
S tlt E.&69 f i.88
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of LOS Angeles BUILDING
JOHN A. LAMBIE,Cour.TY ENGINEER ADDRES= �✓� £"_— -_-
CASSAT'T 0. GRIFFIN, Suer OF BUILDING LOCALITY
- --
CCALITY_
FOR APPLICANT TO FILL IN _ CROSS ST. "-
LEGAL
DESCRIPTION LOT NO py'Y� �e. ---- O'NNE'? - - - -
BLOCK _- TRACT MAIL V `-, ADDRESS ) -`___
N.O.OF BLDGS.. -
SIZE OF LOT rd NOVV ON LOT" _ -.-_ CITY TEL. NO,
USE OF _ L.
:+ DISTRICT NO. GROUP { MAP UILDINGS -z.�,..� 'f-^L- - `--Y BK PG
CONTRACTOR {✓/ ,`; '- a'VP --- -- �,. --`,.._ ._ i- — ' �.
ADDRE . y> e r _w — CONNECTION DATA _
SS / .�_ —
rd' r -
r ,f- r.
STATION � ',.� j' DEPTH
CITY
- /Y TEL. N0. Ld r' 6 t/ / — '
----- 4 MANHOLE REFERENC---- E. +- '.. UPP_.
REGISTRATION NO" �- r e.-�I z [] COUNTY ------ LOWER
No DESCRIPTION OF WORK FEE -
TYPE O— a—_----- —
F CONN.ECTIO kms, LENGTH FROM
HOUSE SEWER CONNECTING TO ( Y. CURB P L. M.L.TO P.L.
PUBLIC SEWER_ _ @ $�3:�8
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 0 $3.00
1 OVERFLOW SEEPAGE PIT,DRAINFIELD i r'' P C N0, -
_ LXTN_,C_ESSPOOL_DRYWELL,MA_NHOLE (c4 $2.00
1
HOUSE SEWER CONNECTING TO _
PRIVATE DISPOSAL SYSTEM ((} $1,00 TRUNK PERMIT NO, ROAD PERMIT NO.
i 'O MECT ADDI-i L �� STATE ENCROACHMENT.— -__----_--.-- -_-
�1�7C.= Q , WE. _ 1.00 (,ti PERMIT N0.
i ALTER,REPAIR OR ABANDON HOUSE _.,.----- -----^------ ----
WAST APP _
SEWER OR.DISPOSAL SYSTEM (co ;Y,00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S )PERMIT UO -
--- -- REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE ,1
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS GATE INSPECTOR'SSIG.NATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING - I,
TO THE PUBLIC SEWER. NEW HOUSE SEWER I ,
SIGNED THIS DAY OF �� CONNECT ADDITIONAL
OWNER. OR BUILDING OR WORK
OWNERS AGENT e' ' . � � ' -e 'G�"L' -"^`�-'�`--( SEPTIC TANK,SEEP,PIT(S) -- - --
ADD_RE_S5. _ANDL(RDRAINFIELD
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOLI,] DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR I
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I
1 HEREBY CEP,T!FY 'LHAT I AM PROPERLY REGISTERED AND/UR -� -- ! --"
DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF'
CALIFORNIA OR THAT I '
THE LEGAL ER OF THE ABOVE ABANDON HOUSE SEWER `
DESCRIBED RESIDENTIAL OPE.RTYBACKFILL SEPTI,TANKS
SIGNATURE '^ SEEP.PITS) {"J CESSPOOLS D
OF PERMITTEE
t�
P1
JOHN A. LA BiE,COUNTY ENGINEER VALIDATION ROBERT A.WOOD,CHIEF PLBG. INSPECTOR
CASH
'&A 642 C APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
DEP,11ITMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
BUILDING AND SAFETY DIVISION Et U i U31NG
JCJHAI ACID
A. LAMBIE. County Engineer F
ADDRESS
-ENSEN, Sup't of Building
WILLIAM A. j
LOCAL3TY
N E.1 RES T
OSS
R,
FOR AP
N1 TO FILL IN _ST.
�ICA
7'
7
DLS::R -I'IrJN LOT NO, OWNER
MAI
I-
BLOC K TRACT A rDRE$�� /
01, ULDGS,
SIZE OF LOT NOW (IN LOT CI
Tyl—��' TEL. NO.
USE OF T I
SUILDING5 DSTR!C t�C GROUP MAP PROCESSED BY
5K FG
CONTRATIOR
ADDRESS CONNECTION DATA
SIATiON DEPTH
TEL, N O.
STATE COUNTY MAN-HOLE REFERENcE LJPPFR
-*—v
TYPE or CONNECTION LENGTH FROM
Y. C4 RB
P.- M.L.TO P.L.
SEWFR--- ss.Oo
TANK,SrP.PAGE P!T OR — 4r.- P,C.NO.
Joe-40.
PITS AND/OR DRAII`FlVXL @ $10,00
C R
'U F,�.s TO
TRUNK PERMIT NO. ROAD PERMIT NO.
PFWF 510AL SYSTEM
CONNV--,- D!-:TONA FILOG.Of-,
W 0 R K TO H CY0 S F.-c(VJFH
OVFRFLOW SEEPAGE P17,DRAINFIELD
zxTN..cEssRjOi_oRywELL.MAN 14OLE $5,00 CL
'--A-'7'R.��'LPA!R OR ��UANDON HWY.OR ST.WIDENING
0;SP05AL SYSTEM
PERMIT NO.
INDUSTRIAL
WASTE APPROVAL.
CHARGES
OWNER., PERMIT $1 2 00
Tom CONNCE,
FTION CHARGE FE
AUTHORIZA ION!
I HAVE A" THIS DATE N CON7RACT WITH THE HEREtN NAMED CO?`,V REIMBURSEMENT FEE
TRI.C-.o.' '0 CCI%Nzr:T —iE ABOVE DESCRIBED PXfSTING DWELLING ---
TO t"SLIC SFN APPROVALS DATE INSPECTOR'S SIGNATURE
SIGNFD ..Li
IS —,, DAY OF 19
OWNER
NEW HOUSE SEWER
OWNERS AGE'Ni
CONNECT ADDITIONAL
BUILDING OR WORK
-4L Z
SEPTIC TANK,SEEP,P!T(S)
AND ,T4.
A--KNOWLEI)GE THAT i HAVE' READ THIS APPL(CA7!QN AND!OR DFlAfNriELE)
- 7H 0 V F. "ORR ty
AN TA,E TH N I K AFS, IS .ECT AND AGREE To cow,'Ly
W-H AL, COLN— ORD-NANCES AND STATE LAWS REGULATING
PLOM N., AN;!-' E IA FRS, CESSPOOL ',-I DRYWELL
1" -HAT REGISTERED ANc'-'OR ALTER-REPAIR.SEWER OR
Y
'E E'y i A"" ANGLESPROPER'
LICZNSED A REQ 'y LOS COUNTY ANG STATE OF SEWAGE DISPOSAL SYSTEM
OR -7'�iAT A M '.11E LEGAL OWNER OF, AND INTEND 70 p}SG ON
-ET PLUG AND
DES"R -AL PROPERTY, H.
RESiDc. '4' ARAN CN HOUSE SEWER
SIGNATURE
1�1 F.�l U S,L P T 1 1::TANIS
OF PERMTTTE�
CESSPOOLS
VALIDATION ROBERT A. WOOD
rf. SUPERVISING MECHANICAL ENGINEER
M.0. CASH