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HomeMy Public PortalAbout9339 OLIVE ST_Sewer__ CEE033-IS2APPLICATION FOR PERMIT --/ _ `.,.-�� el oh S.Y2D ' COUNTY OF LOS ANGELES , DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DIS9'�SAL w" BUILDING AND SAFETY DIVISION fsUtL.DING JOHN A. LAMBIE. County Engineer ADDRESS WILLIAM A. IENSEN. Supt of Building L:JCA 77Y NEARFSIFOR API.IC1 NT_TO FII L IN Revs T - — — DE SCRI�PT!ON [.r'I`n,F- T/ `e .✓ r_-�s OWNER MA}L BLOCK TRACT 3 �, AD^vR-:S£ NO- OF BLDGS. SIZE OF .1..07' NOW ON LOT :TY TEL, NO, USE OF BUILDINGS DISTRICT NO,,. GROUP MAP PROCESSEp BY CONTRACTOR ADDRESS CONNECTION DATA CITY TEL NOSTATION DEPTH t_L. + a`✓`xr_ r f '— , - `- n STP TES ' e L REGISTRATION N0 ,y ' COY MAN.HOI E REf'E RE N.,E r ' __- __.._ `'. �- � UNT NT DE ni?7ION L7F WORK FE'E — 1 7, E OF CONNECTION P LENGT} FROM ___ C SEWER OiJN TVNG TO CURB - -SEWER P.L. M L. r0_P.L. 11c _ ..�..L O_ T SEPT _TANK,SEEPAGE JOB NO, ND/OR DAINFIEICO.IMP,NO.PU6fPIT HC USE W C,NNF 3tNC TO TRUNK PERMIT NO ROAD PERMIT_F I PRIVATE DI POSA 5YSTFM ��' $3.00 1 � - 6- ,✓ __. f GNNF_ 7AG0f TlONPL LDC GR AFF'IDAbIT . _WAIVER EASFRENT I RFC JrPC3..Ii3,.�R.NO. �. DA3'E WORT.TO f{J�SE WEF $3.06 ++ 77�y$Fgq -.-._ _._ -- CSVEriF t:7 dv SEE?A.:E PIT,f,DRA NF7E{,S .EX1 N..6ESSFOiL,DR.1W_.F_.LL.MANH.Oi_E_.___.-..._J_O HWY.04 ST.WIDENINGALTLHEPA;ROR A`ANC_CN HOUSE d}`,T � -_ SEER.._OR LIS_PO_SRL SYS TEh9 .@_ _3_.O_? STATE.ENCROACHMENT PERMIT ND. INDUSTRIAL WAST.APPROVAL CHARGES OWNER'S _-- ._ CONNECTION CHARGE FEEE AUTHORIZATION TOTAL. FEE :_= — -----�� ---------'.-----___-- I HAVE AT 'THIS. DATE A.CONTRACT WITH THE HER£!N NAMED CON- REIMBURSEMENT FEE TRACTOP - CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -_-- -yy./_�,�._}.____-_ -RE TO THE :"JULIC S:WE'R. APPROVALS ALS DA'T'E INSPECTOR'S SiGNAT0.J;RE SIGNED THIS _ 1JAY — OWNER OR NEW H'T_7SF SEWER OWNERS.4.GENT __- '"'. � °J✓`-'t.:,�✓ ate' -- CONNEC'T ADOIT IONAL r V BUILDIN4 OR WORK ADDRESS „EPTI( TANK.SEEP PIT(S) I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS APPLICATION ANDIOP CYi2A1NF{BLD ' 1 AN t7 IAT TH T THE ABOVE S CORRECT AND AGREE 'TO COMPLY A r[{F[ WITH I L nJhPTY ORCIMA NG S AND STATE LiW REGULATING PLUpd RING AND EW_FTS CE,SPOOL 7_] DFvYWE. L IHEREBY FR If�Y THAT' ! AM PROPERLY REGISTERED AND/OR ALTER REPAIR.SEWER OR +! LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE.DISPOSAL SYS"I EM EAI_FCRNIA: OR THAT M THE LEGAL OWNER OF. AND INTEND TO -__.-___-_-_- DI CONNECT P JG AND RESIDE 7N, THE ABOSr Ri Fr.v. RESIDENTIAL PROPERTY. ABANDON HOUSE EWER I SIGNATURE ,$ T SEEP 7RNKS BACKFILLSEP PIT(S) L_1 CESSPOOLS VALIDATION. _ ROBERTA. WOOD SUPERVISING MECHANICAL ENGINEER CK. M.0.