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HomeMy Public PortalAbout9641 OLIVE ST_Sewer__ 76A042P2E-663 3-55 APPLICATION FOR . PERMIT i". 1 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County Engineer County of Los Angeles FLOCALITY LDING / Olive St. li M-J. F'OXC COUNTY ENGINEER RESS e�_CASSATT D.GRIF IN,SUPT OF'BUILDING . .�.�a'� FOR APPLICANT TO ];SILL IN NEAREST - ,�. LEGAL yy nQ,CR1P7[ON OT NO, � � .R� � OWNER BLOCK ,TRACTMAIL vi" Acre _--ADDRESS �_ rW _s - g-qy NO.OF BLOGS: SIZE OF LOT .k.' x Tdv1W L1N�o'...._ CIlY TF,L. NO. i . USE OF DISTRICT NO. ! Gi:i7[1P i SaWar =at, SK PG CG'vTRACTOP ADDRESS ' _ .�," - - CONNECTION DATA TEL. NO. STATION -:`._ _. DEPTH X1 STATE MANHOLE,REF R NCE v UP £R REGISTRATION NO. ,� COUNTYN0, 1 DESCRIPTION OF VIORK FEE --- - ..— — -`.—_. --- �-- -- TYPE OF CONNECTION LENGTH NGTH FROMX10 U.SE at CONNECTING TO 1 Y. CURB P.L, TO P.L. HOUSE.SE'NER CONNECTING TO r �_ PRIVATE DISPOSAL SY T'Eldf1_00 - - CONNECT A{'�iTIONAL BLDG. OR ? C NO _ zt FxKTO HOUSE SEWER 1,00 �. CC.-1 t NC_ R_ -- `— ALTEOR RCp4 P EXI 1It G m __ EH C'R, DISPOSAL SYSTEM _ � 1 On TRUNK PERMIT NO, ROAD PERMIT NO. ---� DISCO_lNECC AND ABANDON SEWER ( I `— AN DIS ASISTAM, _ 00 _ STATE ENCROACHMENT O -- —`-- PCRh�sT NO - - kPTiC TANK, S R INDUSTRIAL PAGE PIT O TS AND/OR DR INFIELD 2 0:?( w AL P g C SS�C7UL DRY4EE'L _~ -'� --- -WASTE APPROVAL CHARCES CONNECTION CHARGE FEE O ER's PERMIT IS TOTAL ARES1 BURo...®..R,SEFI�Nf N'FEE FEE ! � ,W I HAVE THIS DATECONTRACTED WIT14 THE HERUN NANHED CON.- TP,AC Jet TO CONNECT THE ABOVE DESCRIBED FX STING D uELLING d$I�'F�I�O�'�sLS � DATE [4NSPEC.fOR'S SIGNATURE._ TO THE PUBLIC S -d Eft SIGNED T:tIS L 'd Or — Dec. NE%V HOUSE:. "ER CO� 13 [ __ OVINER OR .'77 t NN CT ADi ITIONAL OWNERS AGF,NT.,y!, 4Flt xC q ''--,---�- ---� ter BUILD NO OR vN 012tC—._.�.._ —_ SEPTIC TANK F_P, PITlS) ,ADDP FS AND/OR UrtA.tNt Y 1 HERESY ACKNGTYLEDUE THAT 1 HAVE READ THIS APPLICATION CESSPOOL 0 DR -W Yd1=Lie C? AND STATE THAT THEABOVE I CORRECT T AND AGAPE f0 COMPLY WITH ALL COUNT' ORDINANCES AND STATE LAWS REGULATING; ALTER `�E PA(R SEWER OR. PLUMBING AND Eh'EY.,. SEWAGE D;SPC) AL SYSTEM I HEREBY C"TP Y THAT I AM PROPERLY REGISTERED ANCHOR — LIC NS U A5 REQUIRED BY LOS ANGELES COUNTY AND STATEOF DISCONNECT PLUG AND CALIPORNiA. OR T'AT I AM THE LEGAL, CWNWR. OF THE ABOVE ABANDON HOUSE SEWER DE.S'CRIW.ED RESIDENTIAL PROPERTY /! BACKFILL SEPTIC TANKS�Ij SEEP.PIT(S)_El CESSPOOLS$ - OF PERmiTTEE m _ _ IN tNILLIAIVI.l.PDX.COUNTY ENGINEER VALIDATION R.A.WOOD.CHIEF PLUG. INSPECTOR k 3 81 9RT"k DEC, 6.5 0 911