HomeMy Public PortalAbout9154 OLIVE ST_Sewer__ APPLICATION rOR PERMIT
COUNTY OF LOS ANGELES SEWER--SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION au�Lrs�ss
JOHN A. LAMBIE, County Engineer E
CASSATT D. GRIFFIN,Supt of Building OCALITl = �" w s
Ow fNEAREST v'ti
F , APPLICANT TO kll.t. ROSS
LEGAL �q I *
DESCRIPTION d oIL ND - e,y* r* d� t>,s i.V AT OWNER
fes, toe,?,4�sP'.` a CW ;AAIL
BLOCK.� TRACT vp yr-
ADDRESS,
NO.OF BLDfGS.
{' o 4 bc. Y T
S;ZE OF LOT +e � NOW ON LOT .r✓ aITY IS. c`.�- ` TEL.NO.
USE OF _
N0. .GROUP MAP ROCESSED 31r
- 'SK PG w
CONTRACTOR
_ m a L
ADDRESS - CONNECTION DATAdJ
jJ
CITY TEL.N0. r t7- STATION >,,., r °, DEPTH
I ,e t r e` STATE MANHOLE REFERENCE _UPPER
REGISTRATION NO k} COUNTY � i ':L EYYO�R�
N0. _LESCRIFTTON OF WORK FEE
HOUSE SEWER CONNECTING TO
f UBLiC SEWER
-- C� $3.00
TYPE OF COII"�1'CTION LENGTH FROM/
SEPTI;TANK,SEEPAGE PIT OR
FITS AND/OR DRAINF'IELD @ $3.00 Y. CURB P.L. M.L.TO P.L.
0 E-F OW SEEPAGE PIT,DRAINFIELD
EXTN.,CESSPOOL,DRYWEL.I_,MANHOLE G $2.00
HOUSE SEWER. CONNECTING. TO ".,f "`1 P.C.NO.
PRIVATE DISPOSAL SYSTEM f 'St.00 "O.IMP,T;IO. JOB NO.
CONNECT AODIT?ONA:L,BLDG.OR - -
i WORK TO HOUSE SEWER @ $1.00 BUNK PERMIT T10. ROAD PERMIT N0.
ALTER, REPAIR OR ABANDON HOUSE ',TR'EE ENCROACHMENT
SENYER OR DISPOSAL SYSTEM @ $1.00 'ERMIIT NO.
INDUSTRIAL
®WASTE APPROVAL
:CHARGES
OMER'S
ERMIT $ 2 �00 CONNECTION CHARGE FEE
AUTHORIZATION ATION TOTAL FEE FEIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAKED CON. ����� v>�af� DATE 99'.NSPEeTaR's SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING 1
TO THE PUBLIC SEWER,
SIGNED THIS /JAY OF—19—I9— YiFW HO I<E'SEWER
OWNER OR. Y ONNECT ADDITIONAL.
O"WNER.sAGENT " 'wet., "'� =. :E:..� a 4, '��a�® .::.j
BUILDING OR WORK
AtlDRESS r_I, - SEPTIC TANK,SEEP,PIT(.$)
.AND/OR DRAINFIELD
I HERESY ACKNOWLEDGE 'THAT ) HAVE REA THIS APPLICATION r AND STATE; THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL 0 DRYWELL Q
WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER.OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM!
I H}RE6Y CERTIFY THAT I AM PROPERLY REGISTERED AND/OR NN
DISCOECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT
HOUSE SEWER
CALIFORNIA OR THAT 1 ,AM THE LEGAL OWNER, OF THE ABOVE -
DESCRIBED RESIDENT#AL+ROPERTY. LACKFILL SEPTIC TANKS FJ
SIGNATURE r SEEP.PiT(S) 0 CESSPOOLS
OF PERMITTEEcly.. i
�P VA=ATIOP1 ROBERT A.WOOD
U.0. Quit VU'P IAIV�SII.1G MECHANICAL,ENGINEER
g