The URL can be used to link to this page

Home My Public Portal About10534 OLIVE ST_Sewer__ 4-7 '9AH�2D APPLICATION FORIPERMIT 'EBCB�-88 7 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL 1 DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION `UDREssG 3b j JOHN A. LAMBIE, County Enainees CASSATT D. GRIFFIN, Supt of Building LOCALITY FOR APPLICANT TO FILL IN CROSS ST. %t-r' , LEGAL i` DESCRIPTION LOT NO. i F _OWNER -r .: BLOCK TRACT MAIL Js ADDRESS '. /,— T Rj t NO,OF BLDGS. t SIZE OF LOT NOW ON L,OT t CITY ?` TEL, NO, USE DI BUILDINGSBIC ,DISTRICT NO. GROUP MAP PRO ESSED BY, CONTRACTOR -1 ' r r`,,. _- ° P� r+ ADDRESS =J" .: / ,-�r ? -r,, - CONNECTION DATA , , p F 'CITY STATION ^ DEPTH .. SPATE MANHOLE REFERENCE UPPER REGISTRATION N0. ay COUNTY LOWECy'' NO. I - DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER $3.00 TYPE OF CONNECTION LENGTH FROM^ SEPTIC TANK,SEEPAGE PIT OR Y� CURB P.L. M.L.TO P.L. PITS AND/OR DRAINFIELD @ $3.00 - OVERFLOW SEEPAGE PIT,DRAINFIELD _,,: gf' - F.XTN,.CESSPOOL.DRYWELL $2,00 js HOUSE SEWER CONNECTING TO CO.IMP.N0. f""�� 10 C.B N0.° PRIVATE DISPOSAL SYSTEM @ 51.00 CONNECT ADDITIONAL,BLDG.OR. TRUNK PERMIT N0ROAD PERMIT N0 WORK TO HOUSE SEWER @ . .$1.00 r ALTER, REPAIR OR ABANDON HOUSE STATE ENCROACHMENT SPWER OR DISPOSAL SYSTEM C!> $1.00 _PERMIT NO. J �. �`r ,c,:_. INDUSTRIAL WASTE APPROVAL _ CHARGES OVMER`S PERMIT $ -00 CONNECTION CHARGE FEE AUTHORIZATION I TOTAL FEE ' — REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE, PUBLIC SEWER. SIGNED THIS DAY OF 19— NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.AND/OR DRAINFIELD HEREBY I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRY_WELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I jAM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY OS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AN,, THE LEGAL OWNER OF THE ABOVE — -- �- DESCRIBED RESIDENTIAL PROPERTY BACKFILL SEPTIC TANKS ❑ SIGNATURE '� A � SEEP.PIT(S) El CESSPOOLS E)OF PERMYFSE t �° - VALIDATION ROBERT A. WOOD 0. GASH SUPERVISING MECHANICAL ENGINEER APPLIdATION FQF�t PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION APRE D §G Vit ' J S A, LAMBIE, County Engineer ILI'1 `- 6ASSATT D, GRIFFIN, Supt of Suildireg LOCALITY _ NEAREST FOR APPLICANT TO FILL IN CROSS ST. ' LEGAL l DESCRIPTION LOT NO. �� OWNER BLOCKg TRACT t fs >; MAIL ADDRESS f a•` t � .s"t �' 2'' IL2 NO.OF BLDGS. SIZE OF LOT NOW ON LOT CITY` -' < ✓' TEL. N0, USE OF - - - - BUILDINGS PIP a DISTRICT NO. GROUP MAP PRB�E3 D$Y PG i e ccNSRAcsoR Ab l P. GOI3,str. ADDRESS. ZZ5 W Bryana CONNECTION DATA CITY ` ` TEL,NO. 8-6565 STATION i t-1DEPTH 168579 STATE MANHOLE REFERENCE f � �✓ UPPER REGISTRATION N0. COUNTY '-`"�"� �r NO. DESCRIPTION OF WORK FEE — HOUSE SEWER CONNECTING TO - PUBLIC SEWER Cl) $9.00 r i" TYPE OF CONNECTION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P7, M.L.TO P.L. ,9 - PITSAND/ORDRAIN FIELD @ $3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD - EX'TN..CESSPOOL,DP.TWELL @ $2.00 - — .— HOUSE SEWER CONNECTING TO P.C.NO. PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. NO. £t' � JOB NO. CONNECT ADDITIONAL BLDG,OR WORK.TO HOUSE SEWER $1.00 TRUNK PERMIT NO. ROAD PERMIT N0. @ ALTER,REPAiR OR ABANDON-HOUSE STATE ENCROACHMENT SEWER.OR DISPOSAL SYSTEM. @ $1.00 PERMIT NO. INDUSTRIAL. WASTE APPROVAL CHARGES OWNEWS PERMIT s 2 00 CONNECTION CHARGE FEE AUTHORIZATION� .TOTAL FEE .,.._t ��- c';� REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH 'THE HEREIN NAMED CON- TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE- TO THE PUBLIC SEWER. �� SIGNED THIS DAY OF i9ti _NEW HOUSE SEWER OWNER OR -� - CONNECT ADDITIONAL Tj- OWNERS AGENT ,.g BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.NT(S) AND/OR DRAiNFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS COPP.ECT AND AGREE TO COMPLY CESSPOOL. ❑ DRYWELL Q WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL L SYSTEM I HEREBY CERTIFY THAT` I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED 4Y LOS ANGELES'iCOUNTY AND STATE OF DISCONABANDONECT HOUSE SEWER. CALIFORNIA OR THAT I,/AM THF LEGAL rDWNER OF THE' ABOVE DESCRIBED RESIDENTI,A9:I'PROFERTY. BACKrILL SFIC TANKS [� t SIGNATURE f �' f SEEP CES PIT(S) I� SPOOLS [). OF P£RMITT1 t 'F I--VALMATION ROBERT A. WOOD cx. ,, p,o. CASH SUPERVISING MECHANICAL. ENGINEER