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HomeMy Public PortalAbout10541 OLIVE ST_Sewer__ .,✓ v _ f i al Y .. :Eaaa 50-53 5A642D APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ,EWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION U i LDI N1 JOHN A. LAMBIE, County Engineer Dn ES 4� � WILLIAM A. JENSEN, Supt o: Building OCALITY rR EARECT FOR APPLICANT TO FIM, IN RO5; ST -- - -- - - -- - -- - DESCRIPTION LOT NO OWNER MAIL BLOCK TRACT / ! ' ''' ADDRESS NOY. OF SLOGS, SIZE OF LOT NOW ON LOT CITY TEL.. NO. USE OF D}ST'1ir.T NO.. nUP MAP PROF ESS F_D BY BU LOING -'ti ? � /,{��✓"j- ,y,/ .. jar .. CONTRACTOR Qr=L'Z 't"✓ j 7 4� S'- ADDRESS /7�/ yy CONNECTION DATA --� �,,,. ✓ STATION ". ! DEDEPTHT, CiTv i iF.L. NO � ----- I TATE MANHOLE REFERENCE 7 -, �--- -.STRATI�SCR PTtOtd O W ✓ l.� COUN9"Y LOW EP REGI ORK FEE .-. - -.^ _ Td'r-T r1 Ci3N'��CY4t]N L.E3YG'I'H FR)�iM C SG SEWER CONNECTINa YO Y ��,.7{IQg. P.L. M.L TO P.13'. PG SLC SEWER @ $5 00 SEPTIC TA F_ NK,SFPKdE PIT `O OR j ."S aND,'OR DRAINFIELO $10.00 '� HMP. NO. J06 NO -_ PERMIT NO. ROAD PERMIT NO. I HOUSE SEWER CJ"1 Nc C'1'I'dG'i0 TRUNK PRY E'7 S JSAL SYSTEM ® $ ,00 - 5- -T_ —_ _.T- CONN CT ADD f'ONW BLDG UR AFFIDAVIT WAMA . EASBMf NT RECORD. INSTR.NO. I DATE I WORK TO HOUSE.SEW EP C� $3.00 � •OVERFLOW SEE-AGE R17 DRAINf.EI..D EY. N CFSSPOOL.,DRYWELL.MAN HOLE @ $5.00 . —� _._.._-_ HWY,OR Sr.WIDENING IAfi Ei2.RFP.A(ROR BANDON HOUSE DISPOSAL SYSTEM $ B'0O. fE ENCROACHMENT ' -- PERIvIlT NO, INDUSTRIAL ( I WASTE APPROVAL CHARGES OWNERMIT c'_0 ------ —----'— -- ---- --—----—._ AUTHOT 'pry —- RIZATION TOTAL FEE ✓ c., CONNECTION CHARGE FEE .I HAVE AT 'YHIS DATE A CONTRACT WITH THE HEREIN 14AMED CON. REIMBURSEMEdNT_FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED .EXISTING DWELLING ---APPROVALS --_ _�y-A_ L___-.__.,_.- TO THE PUBLIC SEWER. APPkIOVALSDATE k.INSPECTOR.S.SIGNATURE .SIGNED THIS_. DAY" OP 19.,_ OWNER Oft NEW HOUSE SEWER ' OWNERS:AGENT '- -"- - CONNECT ADDi TIONAL BUILDING Oft WORK I r _ _ ADDS&E5S _ _- ---___-_- -- - SEPTIC TANK SEEP PIT(5) - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I —I AND/OR DRAINA-I ELD IF-- AND STATE THAT THG ABCYE !Ei G6t?RFCT AND AGREE .O COMYLY - .--- --------- 1 --.. ._._ 'WITH ALL COUNTY 0P IDINANC'E$ AND STATE LAWS REGULATING PLUM BiNG .AND SEWERS. CESSPOOL ❑ DRYWELL E] HER EDY' CERTIFY 7HC .AT AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SF_W ER OR-----�- -----i--�T------�-- LICENSED AS. REQUIRED I3Y LOS ANGI:ES COUNYY. AND STATE OF SEWAGE DISPOSAL SYSTEM i C.A I:iFORN1A OR THAT I AM THE LEGAL.. OWNER OF, AND INTEND TO Z.IbCONNFCT PL1G AND �- - RESIDE. IN THE ABOVE DESCRIBED '2ESIDEN IAL PROPERTY ABANDON HOUSE SEWER `_ _ SIGNATURE_ BACKFILL.SEPTIC,TANKS ❑ �_ I OF YERMITTFEy -- - -- SEEP.PIT(S) El .,Ea5POOLS VALIDATION ROBERT A. WOOD d M.O. CASH SUPERVISING MECHANICAL ENGINEER CK-. - F'^7 A64 °° 63 sE808Asaz� APPLICATION FOR PERMIT �� CL COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL. sG DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION TAD:DRESS LDING JOHN A. LAMBIE, County EnyineoE _ - -WILLIAM A. JEN"S"EN, Supt of Bui dingFOR APPLICANT TO FILL IN DSS ST --_ - - -_ I7T/f, bESG.RI !ON I OT NO .tom _'S.r OWNER MAIL BLOCK T'RACI f %'' ADDRESS NO. OF BLDGS. SIZE OF LOT NOSY ON LOT C-17Y TEL, NO.. USE CA -- OISTRI P NO. GRO!,.P MAP PROCE SED By BUILD NG.S E7Yh. PC' ADDRESS 3 — CONNECTION DATA .� CI t fi .�„�F 40 STATION Lam__ '4 _. q/�� f Tf MANHOLE REFERENCE ?y L - ..RE'G!S FA ION N7. Y. I ' OUNTY _ I.R NO f ESCR Tl0i`J OF L'i10 RK FEE TVPE OF,EbNN CFION LENGTH FRO4 -, HOUSE "EW h ONNECTING 70 L.—_ M:. TO P L_ - '�Pl 91 C SEW C i --.-_L.$5.00 - _. NO. TIC,TANK -.PAC E rIT OR CO. IPSP NO. -' ! JOB NO. c 73 AND/OR LF A!Pr F"IELD '� J10.00 _ .--.--_,-_ _-_—. _ _ �"`•` H J. -Ci =SEWER R NNE T°NG TO TRUNK PERMIT NO. ROAD PERMIT NO. ` FRI ATE C PO AL SYSTCM CC> $:?9.00 _ ____ 'l lNEC' CD ON-AL BLDG.OR ACFiDAV! WAi'+eW EASEMENT rRECORD.INSTR NO. I"- DA'iE WQRK-0 F C'' SEWER @ $3 00 ..r OVERFI.O:I S.EPAGE PIT,DRA.INFIELD ! _ _- �. __i: ..._.. 9L EX!'?4.,C E SS POO L.DR YN ELL.,MA NHO LE 0 $'a,00�. ..__-_._. _— __ - _._ —__ H'WIy OR T..WIDENING i AL fER:,REPAIR flR ABANDON HOLJSE I DISPOSAL Y._TCM $3:00 5TATE N 'ROACH MENT -- - --- _.- __- _ 3 Pr.RMIT Na = e -s---=— Ih DU 57RIAL j JI WASTE APPROVAL •F CHARGES OVVNER PERMIT _ - - -- - ------ ----- AT)THORIZATIO TOTAL FEE r CONNECTION CHARGE FEE 'I HAVE AT THIS DATE. A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO C ON'NE_"T THE ABOVE Dr.SCR18fD EXISTING DW FLUNG -----_APPROVALS__-_ _-_r_ TO TH_ PUB.LIC. SEWER, APPRO V ALS tN6PEGTOR SIGNATURE SIGNED THIS DA'Y L R OR NEW HOUSE SEWER. T+.S AGE N'I'�._ CONNECT -..-- _------_ .---.'— CON±�9 E..T ADDITIONAL BUILDING OR WORK SS_____ _ SrRTIC TANFC.SEEP PIT(S).R"aY A NOW'I_LDGE, THAT I NAVE READ TH15 APFLlk-AIION AND.'O-ORAINFIrLO TrE A90 VEL TATE TYAi 'S COREGT AND AGREE TG CC�MFLYALI �..CUN YORDINANCES AND STATE L:>;WS REG�UL.ATING CESSPOOL Q DRY'WELL N PNU S WEBS.REi:Y r If Y THAT ! AM P OPEFLY RFGISTER 7 ANCi/UR ALTn^ RF PAR,SEWER OR S D AS R Qi JIRED RY LOS ANGI ES OUNIT AND STATE OF SEWAGE DISPOSAL SYSTEMCIRNiA OR. THAT 1 AM THE EGA OWNER OF AND INTEND 'TO DISCONNECT PLU AN E IN, THE A 'E D „C'21FFD 4F_SIDE'N"fAL PROPERTY.. ABANDON H©USE SEWR TUREBACKFfLL SEPTIC TANKS TEE""" --_- .SEEP,RSi,S) L] CESSPOOLS ❑� VALIDATION ROBERT A. WOOD SUPERVISING MECHANICAL ENGINEER j CK., M O. CASH Ww e " - �1 "•