HomeMy Public PortalAbout9822 OLIVE ST_Sewer__ DEPARTMENT OF COUNTY ENGIIIVEER SEWER--,SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANG}EXMS
WILLIAM J. FDX, COUNTY ENGINEER BUILDING o�
ADDRESS
FOR APPLICANT TO FILL IN LocALITY (/_ g -
ADD EISS JI + CROSS ST.
LOCALITY P DISTRICT NO. SERIAL NO. PERMIT N0.
NEAE
CROSS ST: QJClT_L!J F�._ A ��- � S
�' E DIED Ready for Inspeotlon DATE ISSUED
OWNER VtllfP.l� 1�
MAIL � ���� USE20NE OCCUPANCY MAP J
ADDRESS I
BK PG
CITY a TEL.NO .�
CONTRACTOR � y I. 6Fr r . CO.IMP.N0.
ADDRESS, ° JOB.NO. �+
CITY Af?fTEL.NO. ', 4� fof TRUNK PERMIT N0.
TATE
REGISTRATION NO. "-8e- ® COU TY'
ROAD PERMIT NO. �+
LEGAL
DESCRIPTION LOT NO. s STATE ENCROACHMENTPERMIT NO.
BLOCK - TRACT �/ WASTE AP APPROVAL
SIZE OF LOT
NO.OF BLDGS.
NOW ON LOT CHARGES
USE OF ���l /f e-4
,�r''9c W
BUILDINGS � fy F- t ef j � CONNECTION OgRGE FEE
NO. DESCRIPTION OF WORK FEE a3 REIMBURSEMENT F
HOUSE SEWER CONNECTING TO
PUBLICSEWER Q $ 3.50 r
HOUSE SEWER CONNECTING TO ' RECEIPT N0. DATE I BY
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 I
ALTER OR REPAIR EXISTING NO. DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNAND/OR DIS SAL SYSTEAND M SEWER 1.,00 I CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION/ DEPTH
CESSPOOL—D RY W EL L
SPECIAL CONDITIONS ONLY 2.00 MA'NH EFERENCE'
/5 P R hawAR
TYPE OF RECTION LENGTH FROM /
OWNERS PERMIT $ I. I 00 M.L.TO P.L.
AUTHORIZATION `TOTAL. FEE I�J ✓rr7
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS. INSPECTOR'S'SIGNATURE DATE
DWELLING TO THE. PUBLIC SEWER
���pp�9���yy NEW HOUSE SEWER w
SIGNED THIS____..._ ..__DAY OF.....s:.•%..�___ _.r__1 � r . .
OWNER OR f'" CONNECT ADDITIONAL.
OWNERS AGENT..._j�/ A ef3� _ BUILDING OR WORK
r . !7 .-. ._ r._.._.....__.
• SEPTIC TANK,SEEP.PIT(S)
ADDRESS..... a,l.. ..__ . _._. AICD/OR DRAINFIEL-D
1 HEREB ACKNOWLEDGE THAT I HAVE READ THIS APP.LI- CESSPOOL[] DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER.REPAIR.SEWER OR
REGULATING PLUMBING AND SEWERS. -SEWAGE OISPOSALSYSTEM
I HEREBY CERTIFY THAT 1 AN PROPERLY. REGISTERED
AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUG
AND STATE OF CALIFORNIA OR THAT 1 AM TILE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RRESIDENTI 355ROPERTY: BACKFILL SEPTIC TANKS
SIGNATURE ��jj / SEEP.PIT(S)[:] CESSPOOLS❑
OF PERMITTEE-aa ;7 �_._J 1.f :__ ✓ iF`;
76.A642D 663 1/53
24650 INSERTs�
CE80fr66O�„� ,
7EA542D APPLICATION FOR PERMIT 7
SEWER-SEWAGE DISPOSAL1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILRlNG 4
BUILDING AND SAFETY DIVISIONADDRESS '. -z,
iOHN A. LAMBIE, County Engineer
WTILLIAM A. JENSEN, S'up't ai Building LOCALITY 77—
NEAREST a
FOR APP'LICAN'T TO FILL IN CROSS ST. p �
LEGAL r
DESCRIPTION LOT NO. �.✓” OWNEfi -- "�
BLOCK TRACT r a '} MAIL
;'e'^ ADDRESS
NO.OF BLDGS. * - ,r' -
SIZE OF LOT NOW ON LOT CITY Ud 4TEL. N0.
I
USE OF �` - ;
DiSTRICTNQ. 4ROUP1 fMAP PROCESSED BY
PG
CONTRACTOR ' - .>•�''4 S
Y
ADDRESS
CONNECTION DATA
✓:: f` ;ter STATION DEPTH
CI >> TEL.NO.
STATE MANHOLE REFERENCE UPPER
REGISTRATION NO. ,,3` COUNTY LOWER
NO. DESCRIPTION OF WORK FEE
HOJSE SEWEPCONNECTING TO
PUBLIC SEWER C.) $3.00 T PE OF CONNEC ION LENGTH FROM
SEPTIC TANK,SEEPAGE PIT OR Y. C U Ala P.L. M.L.TO P.L.
ITS AND/OR DRAINFIELD P $3.00
OVERFLOWSEEPAGE PIT. DRAINFIELD
EXTN..CESSPOOL. DRYWELL @ $2.OQ
HOUSE SEWER CONNECTING TO P C N0,_.-`
PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP.N0, JOB No. y.
CONNECT ADDITIONAL BLDG.OR f TRUNK PERMIT N0. AD PERMIT NO.
WORK TO HOUSE SEWER @ $1,00
iALTER, P.U,k,;i-4)P ArsAVDON HOUSE I STATE ENCROACHMENT. " C4
SEWER 0$D': { $9' M @ $1,00 PERMIT NO.
J1 INDUSTRIAL
WASTE APPROVAL W
CHARGES
OVNEWS PERMIT 3 2 00 CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE r REIMBURSEMENT FES
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON-
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS � DATE INSPECTOR'S SIGN ATURE
TO THE PUBLIC SEWER.
SIGNED THIS DAY O7 19— NEW HOUSE SEWER
OWNER ORCONNECT ADDITIONAL
OWNERS AGENT ..-7 .�'� " , ':'ti..-a�-^�-_ ;i•, '-�'� BUILDING OR WORK
ADDRESS SEPTIC TANK,SEEP.PIT(S)
- — AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY CESSPOOL 0 DRYWELL
WITH ALL COUNTY ORDINANCES AND STATE; LAWS REGULATING
PLUMPING AND SEWERS, ALTER,REPAIR,SEWER OR
SEWAGE DISPOSAL.SYSTEM
7 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ATE OF DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES OWNER AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR 'FHyAT f AM THE EGAL OWNER OF THE ABOVE
DESCRIBED RESIDE IAL PROPERTY `• BACKFILL SEPTiC TANY;S
SIGNATURE SEEP.PiTgS) ❑ CESSPOOLS
OF PERMITTEE --.
" i�lj
VALIDATION ROBERT A. WOOD
CK. M.0. CASH SUPERVISING MECIiANICAL ENGINEER