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Home My Public Portal About9655 OLIVE ST_Sewer__ 6A^1.09-4 'E 808"-rt 0-71 APPLICATI N FOR P MIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION fAPDRESS UILDING r f f� 4 , 6 I ,IL� � OCALITY-"%'�� <•FOR APPLICANT TO FILL IN EARESTROSS ST. /' ✓�' DESCRIPTION LOT NOOWNER �, r y0•s'� �f1 ( iJIC.�{i,/y,•"9.'" BLOCK TRACT /,,� r, it� 1 ADDRESS ) �r✓,' ) SIZE OF LOT ,+ I,'f)NOWOON LOTSfl _ CITY ' + "�• TEL. NO. !.�3k", q_ .� 9 b BUILDINGUSE OFS y�-d„ � _ - DISTRICT N0. P MAP PR ESSED BY __- Al K / P S CONTRACTORS I-1- /�J ADDRESS �' (�•, g' ,._ CONNECTION DAT � ST TION DEPTH ^�3'7. TEL, NO.y91 CITY � STATE 4 LIC M -HOLE REFERENCE UPPER LICENSE NO. CLASS LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTIONLENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER @ $7.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ 510.00 CO.IMP. JOB NO. HOUSE SEWER CONNECTING TO TRUNK PERMIT N . ROAD PERMIT NO. �2 PRIVATE DISPOSAL SYSTEM @ S3.00 O CONNECT ADDITIONAL BLDG.OR AFFIDAVIT I wAfvEk EASEMENT RECORD,IN O. DATE U WORK 70 HOUSE SEWER @ $3.00 E- OVERFLOW SEEPAGE PIT.DRAINFIELD _ o EXTN..CESSPOOL.DRYWELL. $5.00 HWY.OR ST.WIDENING ALTER.REPAIR OR ABANDON HOUSE � ILEE SPOSAL SYSTEM � $3.00 _ STATE ENCROACHMENT W$7 OO PERMIT NO. D. --------------- - INDUSTRIAL � WASTE APPROVAL Z OWNERS PERMIT $ 3 00 CHARGES AUTHORIZATIONT TOTAL FEE j CONNECTION CHARGE FEE In IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING — TO THE PUBLIC SEWER. - APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT f' CONNECT ADDITIONAL BUILDING OR WORK a� ADDRESS__ SEPTIC TANK.S EEP,PIT(S) ' 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _ WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL Cl DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSE DAS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE�A$JOgV,/E DESCRIBED RE51D TIAL PRO 7R7Y. 3{/Jy ABgNDON HOUSE SEWER SIGNATURE / /'/.ry' /I / � K— BClACKFILL SEPTIC TANKS OF PER MTTTEE_ -,bJy/` C SEEP,PIT(S) Q.--Cr=-.SSfOOLS ❑ VALIDATION SCK, M.0. CASH l 16A 6420-CE808-10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION FRE \FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. OWNER -- MAIL BLOCK TRACT ADDRESS NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY T.L. N0. USE OF BUILDINGS DISTRICT NO. G OUP MAP PROCESSED BY /j�' BKy PG CONTRACTOR :L `�.. � ADDRESS CONNECTION DATA CITY TEL. NO, STATION DEPTH STATE LIC MANHOLE REFERENCE UPPER LICENSE NO, CLASS LOWER NO. -DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB P.L. M.L.TO P.L. PUBLIC SEWER 0 $7.00 P.C.NO. SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD $10.00 CO.IMP.NO. JOB NO: HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM $3.00 TRUNK PERMIT NO. ROAD PERMIT NO, d O CONNECT ADDITIONAL BLDG.OR AFFIDAVIT wJIIV[R I EASEMENT RECORD.INSTR.NO.T DATE V WORK TO HOUSE SEWER $3.00 OVERFLOW SEEPAGE PIT.DRAINFIELD OG EXTN..CESSPOOL.DRYWELL. $5.00 HWY.OR ST.WIDENING O ALTER,REPAIR OR ABANDON HOUSE F- SEWER OR DISPOSAL SYSTEM $3.00 _ STATE ENCROACHMENT W MANHOLE $7.00 PERMIT NO. IL INDUSTRIAL h WASTE APPROVAL Z OWNERS PERMIT $ a 00 CHARGESjam' y AUTHORIZATION F TOTAL FEE CONNECTION CHARGE FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. REIMBURSEMENT FEE TRACTOR TO TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER OWNERS AGENT CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK,SEEP,PIT(S) AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY AND/OR DRAINFIELD WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING [jPLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND RESIDE IN, THE ABOVE DESCRIBED RESIDENT L PROPER Y. ABANDON HOUSE SEWER SIGNATURE OF PER.MTT7EE BACKFILL SEPTIC TANKS ❑ m SEEP,PIT(S) E]�-S.FiSSPOOLB ❑ VALIDATION CK.�"' M.0. CASH ( C. 1 '6A'642D—CE808-10-71 APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER _ BUILDING AND SAFETY DIVISION FNEARE yy r-R FOR APPLICANT TO FILL IN LEGAL DESCRIPTION LOT NO. ---� — OWNER ,} MAIL y BLOCK TRACT - ON V% ADDRESS X t7C> NO. OF BLDGS. SIZE OF LOT G+ NOW ON LOT I CITY TEL. NO. } USE OF BUILDINGS R�/� DISTRICT NO, OUP MAP PROCESSED BY 1f-r'" SK PG A. 41 CONTRACTOR �(r' \i {t�t✓L/"tY ADDRESS o2s3 4- CONNECTION DATAyyy,,, CITY G- TEL. NO. .� STATION 1�7 DEPTH �� ps MANHOLE REFERENCE UPPGA,,,,. STATE ) - LIC ' p LICENSE NO:.. /r i ?t OLASS - ��.,, '^� N LOWER NO. DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y. CURB M.L.TO P.L. PUBLIC SEWER $7.00 P.C.NO �� SEPTIC TANK.SEEPAGE PIT OR PITS AND/OR DRAINFIELD 510.00 CO.IMP.NO. JOB NO.. HOUSE FEWER CONNECTING TO TRUNK PERMIT NO. - ROAD PERMIT NO. d PRIVATE DISPOSAL SYSTEM $3.00 0 CONNECT ADDITIONAL BLDG.OR AFFIDAVIT WAIVER I EASENIMI RECORD.INSTR,NO. DATE u WORK TO HOUSE SEWER S3.00 OVERFLOW SEEPAGE PIT,DRAINFIELD Of EXTN.,CESSPOOL.DRYWELL, @ $5.00 ALTER.REPAIR OR ABANDON HOUSE HWY.OR ST.WIDENING SEWER OR DISPOSAL SYSTEM _ @ $3.00 _ STATE ENCROACHMENT Ivy MANHOLE a $7.00 PERMIT NO. A INDUSTRIAL W WASTE APPROVAL Z OWNER'S PERMIT $ 3 00 CHARGES AUTHORIZATIONI TOTAL FEE 1 iO a0 CONNECTION CHARGE FEE IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWS J APPROVALS DATE INSPI. TOR'S G ATURE SIGNED THIS D4kY OF � y J 19 OWNER OR , gip , �+} NEW HOUSE SEWER OWNERS AGENT i. ,,�%li TS 7 -- CONNECT ADDITIONAL ADDRESS BUILDING OR WORK I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION SEPTIC TANK.SEEP,PIT(S) AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL Cl DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSEDAS REQUIRED BY LOS ANGLES COUNTY AND STATE Or SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEG¢L OWNER F, �IR O DISCONNECT PLUG AND RESIDE IN. THE A DE (AIBF,9 'R SIDEN L P;AoN ABANDON HOUSE SEWERSIGNATURE '/// BACKFILL SEPTIC TANKS ❑ OF PERMITTEE �{ *T SEEP.PIT(S) [1 CESSPOOLS VALID ON CK. M.0. CASH ca1,005 '' ' 3 1 CJ D 10.00- 4