HomeMy Public PortalAbout9230 OLIVE ST_Sewer__ �
S&E,6B9 51.55 APPLICATION FOR PERMIT 1
.�CY. .fi
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
(Department of County Engineer
County of Los Angeles BUILDING
.JOHN A. LAMBIE, CouNTY ENGINEER ADORE S _--
CASSAT'T D. GRiFFi N, SUPT OF BUILDING .LOCALITY
FOR APPLICANT TO FILL IN
NEAREST
ROSS-ST 1 -
LEf,AL ----- -- --`--'—
DESCRIPTIONLJT:NOS .'�' ' OWNER
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MAIL
BLOCK-------- TRAICT �.�, � t�__' ADDRESS
-- N0.OF BLUGS. —
SIZr:RL LOT NOW ON LOT
CITY. ,y z _ _ TEL. NO. -.
USE OF r -
SUCLD1NGS DISTRICT NO. GR CUP - I MAP
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CONTRACTOR "
ADDRESS t.' '
TEL. N0. CONNECTION_DATA - — ---- —
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-- STATION DEPTH
CITY d .i ar' p �--, - .-- -- ------.------------ - ------ -
_'-_-- MANHOLE REFCRENCE - UPPER
` [--yTE Z - - - --LOWER
REGISTRATION NO ( ti_4
__ COUNTY
NO _! DESCRIPTION OF WORK s FEE s- - -�-_-�--.,� -'--- -
.' - -- -- -------- ---- TYPE OF CONNECTION LENGTH FROM -:
-
HOUSE SEWER CONNECTING TO -- ------
�USLIC SEWER @ _g�.Sb l � Y. CURB___.P.L. M,L.TO F.L. :
SEPTIC TANK.SEEPAGE PIT OR j
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?ITS AND`CF DRAiP a LD n, $3.00
---i - ., .,.O.Q P C N O.-,
� .-- ---- , CO, IMP. N0, �`..... 105 -
OVERFLOW SEEPAGE PIT,DRAINF1.ELp
I EXTN..CCS POOL.DRYWELL,MAP{HOLE (i,,
}OJ E SNINER C)NNFCTING TO - _
PRIVATE DISPOSAL S STEM G_? $5.00 _ i TRUNK PERMIT NO. -ROAD PERMIT NO,
k CO'-l"E T ADDITIONAL BLDG.OR y STATE,FNCROACH AENT'_
> WORK 70HUSEWER �t: ! -
OSE R
- -5100^�- C"��' PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE .----_--�-_.--
i
SEWER OR DISPOSAL SSYSTEM - LcINDUS RIA1,. $1_OG _-- WASTE APPPMAL
i
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT r 00 — — - -- — — -- ---- -- - -
'--`I- RE;MBURSE:MENT FEE
AUTHORIZATION TOTAL FEE
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- .------ APPROVALS I DATE I1NSP,:CT0R 3 5, GNATL,RE
-
TRACTDR 70 CGClNECT THE AE01'E DESCRIBED EXISTING DWELLING ...._i
TCT t= PUBLIC SEW-R. NEW HOUSE SE rR-
SIGNED THIS _I)AY OF. 19;_. CONNECT ADDITIONAL
OWNER OR __.BUILDIN.G OR WORK �OWNERS SEPTIC A'EN T_—_____J. ..-..- _.- SEPTIC TANK,SEEP,PITS
ADDR_CSS
AND/CR DRAiNFIELU _
—.f--1'EPFBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I �
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY CESSPOOLD DRYWEL.L0. _I --_�-lA_-
-----------------....----- - ._-.._-_--------
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
_
1 HEREBY CERT'F'Y TNA` AM PROPERLY REGISTERED AND/CR '_— __�,-------_--- ---_-_...
LICENSED AS REQUIRED H! LOS A.iNbELES COUNTY AND STATE OF 'DISCONNECT PLUG.AND i
ABANDON HOUSE SEWER
CALIFORNIA OR THAI' I AM TNf LEGAL OWNER OF THE ABOVF_ ---`-- ---' --------'----i -------
DESCRIBED RESIDENTIAL. PROPERTY-, BACKFILL SEPTIC TANKS L- 9"
SIGNATURE - J , ..: SEEP.PITS) 10 CESSPOOLSi] I
OF PERMITTEE z.
JOT-!N A. LAMBIE. COUNTY Ei'vG1iR.;=ER :.•-VALIDATION ROBERT A. WOOD. t_:I-1IEF PLBG. INSPECTOR
CK.. b.0. CASH -
7 3
L_B 25C10