HomeMy Public PortalAbout9470 OLIVE ST_Sewer__ 76AC,420
a E-663 11.55 APPLICATION FOR PERMIT
DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Department of County Engineer
County of Los Angeles
BU I LDI N G
JOHN A. LAMBIE, COUNTY ENGINEER _ADDREsS
CASSATT D. GRIFFIN, SUPT`OF SUfLDING LOCALITY
NEAREST
FOR APPLICANT TO FI7IN
LEGAL
DESCRIPTION- LOT N01- OWNER
BLOCK TRACT MAIL
ADDRESS
NO.OF BLDGS.
SIZE OF LOT NOIN ON LOT CITY TEL. NO.,
USE OF
BUILDINGS
DISTRICT NO. GROUP MAP
,�Ll
SK PG
CONTRACTOR -S"
-z-
CONNECTION DATA
ADDRESS
STATION DEPTH
CITY TEL NO.
3
2 - -v — MANHOLE REFERENCE 141
REGISTRATION NO, STATE LOWER
NO. 1 DESCPUPTION OF WORK FEE
rYPE OF LENGTH FROM
HOUSE SEWER CONNECTING TO _J;a�ECTION
(1-z $ a.so Y. -40CURB P.L M.L. TO P.L.
PUBLIC SEWER
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINNELD 3.00
OVERFLOW SEEPAGE PIT,CRAINFIELD P. C. N0.
EX T N.,C E S S P 0 0 L,D R Y W E f-L,MA.N Hj L E 6�, $2.OOl1 CO. IMP. NO, 013 NO
HOU'E SEAVER CONNECTING TO
PRIVATE DISPOSAL SYST $1.07 _—' TRUNK PERMIT NO. ROAD PERMIT
------ VA__ _ EM-_ F— 74
1 CONNECT ADDITIONAL BLDG.OR STATE ENCROACHMENT
1 WORK TO HOUSE SEVIER CV, 0
0PERMIT
1 ALTER,RF17AIROR ABANDON HOUSE
°EWER-OR INDUSTRIAL
DISPOSAL SYSTEM
WASTE APPROVAL
CHAR 5
ECTION CHARGE,FEE Fi
OWNER'S PERMIT $ 1 00
REIMBURSEMENT FEE
AUTHORIZATION TOTAL FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAllEDCON-
APPROVALS DATE iINSPRCTOWSSIGNATURE
TRACTOR Til CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER. NEW HOUSE SEWER
SIGNED THIS-P 19- CONNECT ADDITIONAL
OWNER OR �J BUILDING OR WORK
OWNERS AGENT---
SEPTA C TANK2 5
I EEPI PIT(S
ADDRESS-- ANWOR DRAINFIELD
I HEREBY ACKNOWIEDGE 114AT I HAVE READ THIS APPLICATION
CESSPOOLS DRYWELL[l
AND STATE THAi THi ABOVE 15 CORRECT AND AGREE TO COMPLY
WiTH ALI- COUNTY ORDiNANPES AND STATE, LAWS REGUL.ATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
A
I HERFEY CERTIFY THAT I M PROPERLY REGISTERED AND/OR
LICENSED AS RECUiRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND
CALIFORNIA CA THAT i AM THE LEGAL OWNER OF THE ABcVF ABANDON HOUSE SEWER
-
DESCRIBED R:SIDENTI-A� PROPERTYBACKFILL SEPTIC TAMRS
SEEP,PIT IS) LI CESSPOOLSC,
SIGNATURE
-
OF PERMITTEE '�'r�',cvr 2
JOHN A. LAMBIE, COUNTY ENGINEER. VALIDATION ROBERT A.WOOD, CHIEF PLBG. INsPEcTQR