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HomeMy Public PortalAbout9836 OLIVE ST_Sewer__ dk UE808 10.62 f'9.PPL1\.,rf'ts ®Itl � RIZMIT 76A 6420 j COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL- DEPARTMENT OF iiCOUNTYENGINEER 1LLiN'lX AND DIVISION FNE DIN �'° 7ORiN A: LAMBIE, Count Ea 'SS WILLIAM A. IENSEN, Supt of Building ------.- L7x Y ;✓ Xre� EST FOR APPLICANT TO FILL INROS iL 4L J SCR 1 FITION LOT NO .' Re�_2 ' OWNEK L d i- - MAR.. _BI OCK 7 RACT i ADDRESS `- a:, ✓ `�;� p ---- NO. OF SLID 9'Z.E OF LOT NJW ON LOT CITY� TEL, NO. U Or y 10)IS TR ICT NO; GROUP E-. MAP PROLE&!350 By Bu1LCI NQS BK PG CONTRACTOR � _ :' i i✓ `r D -__--_-- CONNECTION a ��p� �r q x��P y}� A DDRE 55 �, . r�p r S..L''�i'C _•^ \i®A'i1tl ELsTd®a, LINA _.._ ,,q f _ '17'Y -a�'y: 'vygr�.-.= '� 7�L. NO. STATION f' tr I 1.,: r DEPTH .---'f �- - STA TE UPPER MANHOLE RF:FERL hrE �o,s< RATION NO.DL GRIPT;ON OF W � COUNTY LOWER � CRK FEE _ TYPE OF CONNECTION LENGTH FROM ---r HOUSE SFWER,ONH TING 70 ' Y. CURB P.L. M.L.TO P.L. PUBLIC SEWFR @ $5.0D __.._ 1...._ �7— P.C.NO SEPTIC TANS< SEEPA G£'PIT' OR ' I CO,IMP.NO. JOfl NO 0 �P'TS AND/OR CRA NFIkLD $10.00 -IL._ R� -_- HOUSE SEWER COh NEL ING TO -- - ----- 1-- I TRUNK PERMIT NO. ROAD PERMIT NO. (..� ' PFIVA TE DI }t SAL SYSTEMS Sa,G(t Ug ._._... -._.._._ - ___..__-.-__, .__-._Y_—__. -._ _..___ ...— ON NECT AUDI`ION4L BLD(7 OR AFFIDAVIT WAIVER EASL?t EHTT RECORD.INSTR.NO,T—DATE � W`JRK TO}OU c FEWER @ S3.Ob -4� - - -. -- -- -- I OVCRF 0W SEEPA PfT,DRAINF!ELD 1 EXIN,CESSPOOL,DRYWFI_L,MANHOLE $S.60 -P--_—�---- NWY.OR ST WIDENING ALTLR.REPAIR(3 trc ABANDON NOOSE �i I '�E\h kR OR DkSPOSAL SYSTEM. Si.co -Sm -, -.-_.... - - I _ — —__ TA[ .ENL ENCROACHMENT _ RO PERM[, NO ---`C _. 8 _s�L—u�-�..�_ ��✓ ti INDUSTRIAL --- ------ --- - ----— _.----- / -_:t_ WASTE APPROVAL _ CHARGES O'U�NER''_ PERMIT $: i oQ —--- -- --' --— — ----- �____ CONNECTION CHARGE.FEE AUTHORIZATION TOTAL FEE 1 `, --- --- — -— —----- --- I HAVE AT THIS DATE: A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLI_NCr ------------ - TO THE ?'UBLIC SEW4 R. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY O F ---- 19_._ --- -- -------�— -T--------------- OWNER OR NEW HOUSE SEWER OWNERS AGENT—_,_____..___.—,- - CONNECT AL3DITIONAL BUILDING,OR WORK I A DD RES^s SEPTIC TANK,SEEP FIT(S) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION E- AND/OR DRAISV F. LD AND STATTHAT THE ABOVE I5 CORRECT AND AGREE TO COMPLY W'THALL C:OUNi! ORDINANCES AND STATE LAWS R€GULATING PLUMBING AND SEWFIRS. CESSPOOL ❑ DRYWELL, ❑ � I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR i LICENSED AS REQUIRED BY L.O5 ANGLES COUPdTY AND STATE O±' SEWAGE DISPOSAL SYSTEM CALWOR WA OR THAT t AM THE'A@""LEGAL, OWFPft��OF AND INTEND TO I _— RESIDE lid, THE AB \` 077FGTr D i0 TJAL, P� PER7Y D AND NEH P UG AND !s dJ ABAN90t! USFSEWER SiGNATURE BACKFILL EP- TANKS�❑ I _---- OF PERMITTEE J !'- S}EP,PlTf S} ❑ CESSPOOLS ❑ VALIDATION ROBERT A. WOOD SUPERVISING MECHAN[CAL. ENGINEER CK. M.O. CASH `'A 4'72 APPLICA ON FOR PERMIT 64?LL COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS -'t-l„ LOCALITY FOR APPLICANT TO FILL IN NEAREST - - CROSS ST LEGAL DESCRIP'TiON LOT NO. / OWNER �(.,�4_ {1 �✓,-L7 �,.- aL,.� f ,• 6^. MAIL BLOCK TRACT f J... _ ADDRESS 'ts .,1- j r, •i 0. OF DG S. ,.�-v SIZE OF LOT�_��.�' _ON _'LOT LOT _-�_._..--- CITY L�-�,L.{;'L. L,?�-,*... TEL. NO. USE OP t A /' DISTRICT�;0. 6t7 UP .'viAP PRO 58ED B'! BUILDINGS s fy `.r.� - Ps -._ -.__- .. ___—.—.. .-._-- B K ONTRACTOR I1 .o o-v l RL__ v tv ADDRESS .�,.('_( r , _--CONNECTION DATA CITU �•�'� TEL. NO. -_ J -��7 ll L� 5TAT10- - DEPTH STATE LIC MANHOLE RE ENCF: UPPER {{ .— LICEPJSE. NO. 7 , VA3 1✓+ C.LA55 e.. •� LOWER —.r — NO. DESCRIPTION OF WORK FEE __ TYPE OF CONNECRSL,1LENGTH FROM HOUSE SEWiN ER CONN€GTG TO Y, _, _- CURE _ RT6,�4•, M.L..TO P.L. PUBLIC SEWER _@ NO. SEPTI-­Cr ,KSE­E P AGE P1 OR O Ti CO.IMP.NO. P17S AND;OR DRAINFf i'LD @ ------- - �--- ' JO HOUSE S WER C:ONNECT'fNG TO TRUNK PERMIT NO. ROAD PERMIT f RI VATE O SPOSAL SYSTEM CONNEC7 ADO 7IONAL BLDG 9R - AFFIDAVIT WAIVER iEASEl6EnT RECORD,INSTR,NO. ZE (¢ lit OUSE SEWER I '` O ERFLCW SE EPAGiE PI..DRAINFIELD EXT,N.-CESSPOOLDRYWELL,MAnMOI_E ------ HWY-.OR 5T.WIDENING ALTER,REPAIR OR ABANDON NO65E SEWER OI'i DISPOSAL SYSTEM .____-_. ._.____-___.__�— _�_ STATE ENCROACH MEN7 PERMIT NO. INDUSTRIAL WASTE APPROVAL CHARGES Ty.7C�W�pNER'S �y PERMIT $_ 3 -p -' ----- ----- - -- AV 1HORIZATION TOTAL. FEE ✓,w�.'0�j CONNECTION CHARGE.FEE REIMBURSEMENT FEE IHAV E AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- T --------- -------- RACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING ------- ---------------------�--'-'•--- ------ TO THE- PUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATURE 5 S SI THI . ` .DAY OF �-- —194_ -.. .- — - - -- — ---� OWNER OR yf If?/` _ $J / NEW HOUSE SEWER OW",FRS AGENT%- OU LNNECT DiNG OR IIIO AL WORK BI ADDRESS.o2-. _ d4'-=3k -F 4[P.f L`�- _ -�`!'-'Y3.2_--6. [ HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION SEPTIC TAN3C BEEP,PIT(S) AIi D/OR DPAiNFIELD AND 570.7E THAT THE ABOVE. IS CORRECT AND AC REE TO COMPLY - .-- WIT}iALL COUNTY ORDINANCF_<_ AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑. DRYW EL L. ❑ IHEREBY CFRT!FY- THAT I AM PROPERLY REGISTERED AND,/OR ALTER REPAIR.SEWER OR 1 LICENSED A5 REQUIRED BY LOS ANGLES COUNTY AND 570.7E OF SEWAGl.DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER lOyJ)AICD INTEND,TO DISCONNECT PLUG AND 1 t- !+.'ESIDE IN, THE ASOVF'"13 CRIBED RE$fD EN71f�L f•R CkPERTY. Jf� ABANDON HOUSE SEWER SIG NA7 C;RE 6� may[+y,. ,.� BACKFILL SEPTIC TANKS 1 OF FERMTTTEE _� 3a, G44 SEEF.PIT(S) CESSPOOLS -___-- VALIDATION CK. M,©, GASH • .� re'gj .:+y. d�~A1a °' tsa.i wAv at1 V Il