HomeMy Public PortalAbout9417 OLIVE ST_Sewer__ E-663
5&E�fiAf ■ LICA i oO■ ® FOR l ■ E■ •M1 ■
5& 68 f2.5m
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles "UILDINGz y--
WM.J. FOX, COUNTY ENGINEER 4DDRES9 ��-741 7
CASSATT D. GRIFFIN,Super c)F BUILDING v
LOCALITY •'tea- w,
FOR AIS
D ----- t'-WANT� `-;-FIINEAREST
EAREs7
GROSS ST
.j
LEGAL
--.SCRiPTION LOT NO ' dI - ¢ OWNER
----
-
BLOCK TRACT :� s ,�' MAIL
- ADDRESS_ .%, jr
NO.OF BLDG5 ✓ ,d y .•,....
SIZE OF LOT NOW ONLOT ,/ _ _ - CITY TEL h'O. s---
USE OF ^— r. — - -. -
_ ' DISTRICT N0.
BUILDINGS GROUP MAP
RK PC
CONTRACTOR 3�1i i y
ADDRESS 59, 3 K" . Clove rl 'Aye. -- CONNECTION DATA
CITY w�2ft'ple City TEL. NO. "'r�"3104 STATION;: �_ .•. ._,�; DEPTH
,� � �� t_I
"`,� � .ter
6 STATE `:r` ~t' MANHOLE REFERENCE .�
REGISTRATION NO, � ❑ COUNTY - �/ _UPPER �-- L 0 ds.R
_�.e
TYPE. . EC,TI014 LENGTH FROM
NO. j DESCRIPTION.OF WORK FEE .Y.__.._ URB P.L. kl.L.TO P.L. -
HOUSE SEWER CONNECTING TO _
�. PUBLIC SEWER
3.50 --
' MOUSE SFW R CONI ECTING TO
_ PFIV.+ E D SPOSALSYsi EId 1,00 __j— - ------
' CONNECT ADDITIONAL BLDG. OR _- _I CO IMP NO ' .N _:.. JOB. NO.:
VvRK TO HOUSE SE ER 1.00
} At ER OR Rr= AIR EXt f}NG _ r z
5ELSCR OR DISPOSAL SYSTEM, I.CO _ TRUNK PERMIT NO. ROAD PERMIT NO. `d ¢r d✓�r.
DISCONNECT AND ABANDON SEWER —+�-^ -- STATE ENCROACHMENT .--
______� AND/ORDISPOSAL SYSTEM1.00' PERMITNO.
srPfic TANK SEEPAGE PIT OR ..
PI SAND/OR DP-.AINFIELp 2.00 - +-_-IV-DUSTIZ!.AL - --_y-
�I
CESSPOOL DRYWF L - -`i-•a—i------ _'NAgrE APPROVAL
— J SP AL CONDI7fOhS ONLY - ' CO i CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT _ _�_� 1 , 00
AUTHORIZATION I TOTAL FEEREIMBUR,55YENT FEE
i HAVE TH:S DATE CONTRACTED WITH THE HEREIN NAMED CON- APPROVALS DATE _INSPECTOR'S SIC-NATURE
TRACTOR TO CONN DWELLINGCT THE ABOVE DESCRi6£D E'USTING DWELLING
TO THE PUBLIC SEI,iJ~,"/ . --
e..1` NEW HOLISE SEWER.
SIGNED T;il5.� 7DAY Or 19
OWNER OR f ^' J. f CONNECT ADDITIONAL
OWNERS AG �r' ...xr r� BUILDING OR WORK -
- 5EPTIC TANK SEEP, PIT ES)
ADDLE S t w ANO/OR DRAINIFIELD I
,r
1 HEREBY ACKNOWLEDGE THAT I HAVE READ T}I1g ` gy-ICATIOP� CESSPOOL DRY\VELL(a]
AND STATE THAT THE ABOVE IS COi.Kd CT AND AGr:E TO CO}d PLY
WITH ALL. COUNTY ORDiNANCES AND STATE LAWS REGULATING ALTER, REPAIR„SEWER OR
PLUMBING AND SEIVERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANDOTt --
LICENSED AS REQUIRED BY LOS ANGELES COUNT'; AND 'TATE OF DISCONNECT PLUG AND
CALIFORNIA OR THAT I. AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER
DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ -
.yd;, �°�C3'�t"riig, 100, off' , C � _iEEP_PIT s- cesSPoolsG _
SIGNATURE + f ....------- ..._
OF PERMITTEE
WILLIAM J.FCX,COUNTY ENGINEER VALIDATION
4.5 In
BY BY
DEPUTY - DEPUTY
BY BY
l�*
DEPUTY DEPUTY