HomeMy Public PortalAbout9845 OLIVE ST_Sewer__ a
75A642D � �1.3-62. APPLICATION FOR PERMIT
7'SA6
COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
10HN A. LAMBIE, County Engineer xcDREss--/-
Wl"IANI A. IENSEN. Sup't of Building ,T!`
LCCAL.ITY
NEAREST
FOR APPLICANT TO PILL IN _ ST.
y
CROSS - ,✓�� y+y
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C E S C R
–CESCF PT 10N LOT NO. _. OWNER_
MAIL
SLOCK TRACT
�,� � v -.,. � ADDRESS
NO. OF BLD GS..
SIZE OF LO.T' NOW ON LOT CITY TEL. NO.
USE OF
BUiLDIN�,S ' j:- DISTRICT NO. GROUP MAP PROCESSED BY
BK PG
CONTRACTOR
ADDRESS_- -,g, ; ,__ .. f y{.r CONNECTION DATA _� -.--- -
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DEPTH - .I
CITY_ --ar—!E-.. —✓ "_&.L TEL N'J. J
"S'TATE MANHOLE REFERENCE
REGrsTRxTIDv No J4 _— r_
COUNT}'
NO. DESCRIPTION OF WORK FEE ----
--�` f TTa OF CON`YE TGI�j LENGTH FROM
I HOUSE SEWER CONNECTING 77 C' k+
.,r Y. . l,R . Q.P.L. M.L.TO P.L.
_----r SEPTIC TANK "cEP 4(.E PIT OR _ ,LL P.C.NO.
x' L'
l!?ITS ANp'/OR Dr7.4INFJEL.D ;� $10 DO 1 CO.IMP NO j 08 NO.
---. -
_ _
HOJSE SEW Eft COFTNECTI N(i TO ---- -- - --- -- �'
TRUNK PERMIT
PRIVATE DISPOSAL SYSTEM L $3.00PERMIT NO ROAD PERMIT NO. (
_D -.._. _
J
_- r i AFYiDAVIT WAIVER' EAS€uE NT I F2EC ORD. INSTR N-0-77--
N-O DATE
BL
CONNECT ADDITIONAL DG
WORK TO WOJ.E.>EWF.R OR
s;3,00
R
- OVi; KLhW'eEE PAGL PIY U-RAk�t FIELD
----- EXTN CESSPOO DRYWE.LL,MA NH OLE'AI- $ .O0 ---- -_-_ - --
-._ -
H{WY.ORST.WIDENING
ALTER
-.REPAIR OR ASA NOON HOU5E I i s
}
SEWER ORD SPOSAIL SYSTEM @ $3.00 STATE ENCROACHMENT ____
PERMIT NO
_-
--. 1hDIJSTRIAI.
_WASTE APPROVAL
OWNERS IaEIi ITS 2 00 saRaEB
CONNECTION CHARGE FEE T
AUTHORIZATION TOTAL .FEE ------__—_--
I HAVE. AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE
-TRACTOR TO CG 'M1(c 1.T THE ABOVE DESCRIBED EXlSTi Nuc DWE 1_IN^ --- ---- -- -- ------ - --- ----
TO 'THE. FURL. SEVY R-.. APPROVALSDATE :h5PEC70R SIGNATURE
i
SIGNED THIS-----DAY a�-- .._ r --- --------------------}---__.—_._._.-- ------- - _--------.
GWiIEP OR NEW HOUSE SEWER
OWNERS AGENT[ ___
--'-- DONNE-T'ADDDITIONAL.
SUiLDING OR.WORK
ADCJRFSG _
I-- _ _—_— --- __ ___ _-_ __._ ._._ SEPTIC TANK SEEP,
F HEREBY' ACKNOWLEDGE L.FC.UF THAT I HAVE READ THIS APPI,Ir AT'ION AND/OR ORAINf-iF-C
AP•7D STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITHALL COUNTY ORD.INA,NCES AND STATE LAWS REGULATING ElPLUMBING [IAND SEWERS. CESSPOOL ORYWEL'i
!
HERE13Y CERTIFY THATr .AM PROPERLY REGISTERED ANO/OR ALTER.REPAIR..SEWER OR
LICENSED AS REQUIRED SY : OS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM
CALAFORNi.A OR THAT i AM ;Yrfr LEGAL OWNER pF, AND INTEND TO --E-7-CT
_ ___.___._—.-
+'` '� Di -..ON NECT PLUG AND
RESIDE iN, THE ABC D SZR1BED REWI>ENTLAtP r FERT'Y SEWER
RI NOON H
SIGNATURE �___._. SEEP,FILL'.E (�F TANK. ❑ _._._.-. ---___-_.._-.
r _
PIT
OF PERM!TTP-E La
f VALIDATION ROBERT A. WOOD
i
M.O. CASH SUPERVISING MECHANICAL ENGINEER
dr-E 9.�`-.90' 3. � C..� ' �,i5'e``" � �r�' � J$
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76A6420 APPLICATIQN FOR PERMIT
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING ANIS SAFETY DIVISION SUYLDING
JOHN A. LAMBIE, County Engineer ADDRESS -----
WILLIAM A. JENSEN, Supt of Building + 1
LOCALITY
NEAREST —
7BLOCK
R APPLICANT TO FILL IN -R°SS ' -: '" � ' _--
- ✓-
LOT NO OWNER
-._Y-- - MALL.
TRACT< 9 V 1 wr / �y� e, ADDRES NO. OF BLDGS.
SIZE OF LOT NOW ON LOT {,.I TY" TEL. NO.
USE O`
E,111 LD i NGS ,� ITRi T NO GROUP MAP PROCESSED BY
PG
CONTRACTOR
��` - - - --
ADDRESS f ✓ y C_- CONNECTION DATA zi
CI'iY ,.' �S,vI.A "�. tlty� TEL C'
N . f p+'',, i '�__-. ST'ATIOF' ; ._ DEF TF+ -
RITE ISTRATIOrvI M / "F_, --STATE MANHOLE REFERENCE -
L UPPER
UN
:oN'vEC i I6Z LENGTH FROM
NO. � DESCR 71011 OF WCJR4C FEE TY F o J
HOUSE SEWER CONNECTINGTO Y ,-CJJ7¢B' P-L M:L TO P.L._--
. .._::.-Lro-
U5L-.SEWER $5-00 - -
..-.
___
_ ....__-
SE TI. "TANK...,EEPAG,:PiT OR I -- ---�- f P.C.FCN .
CO.IMP.NO Ji .i1 JOB NO.
PITS AND!OR DRAINFIELO � $10.00 ---
HOUSESEWER CONNECTING To
PRIVATE DISPOSAL SYSTEM @ S3 00
L NhFw
C.T ADD TIONAL BLDG OR AEFI.DAVI WAIVER EASEMENT REvURO®t N$TR.INO9i D.A7:E
y`
TRUNK
T
I WORK TO H04 E SEWER @ .�3 00
_—_
€XTN -R POJ R RYWELL. HAM1U,g E SS 00 _—_r— __ HWY.OR ST WIDENING
1 AL7Eit.REPA)R OR ABA ND OTF H�3kl'tSE
SEWER OR,DISPOSAL BY^,PF"EM $i 00 -- - -- - -
_r ,._ -: ..a.�. _— STATE ENCROACHMENT
PERMIT NO.
INDUSTRIAL
I
WASTE APPROVAL
I '
ME,I`S cynRy
OVEs
PERMIT
.CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE r ' ? , 41 ----- -- - ----- -- -- - -----�--
IHAVE' AT THIS DATE A CONTRACT WITH THE. HEREIN NAMED CON REIMBURSEMENT FEE
TRACTOR 7O CONN=CT THE ABOVE DESCRIBED EXISTING DWELLING
T6 THEPU>°iL IC SENER' APPROVALS LATE INSPECTOR'S SIGNATURE
SIGNED THIS DAY ®`--_--_._- f9_--- ---------- ---"-t....
I
OWNER OP NEW HOUSE SEWER
OWNERS __
CONNECT ADDITIONAL
BUILDING OR WORK
A ODRE S ._ _
---- - _ ---- SEPTIC-YANK P SEEP (S) - -
I HFREBV ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFiF D I
AND STATE THAT THE AMOVE IS i3ORRECT AND AGREE T'O COMPLY
WITHi ALL COUNTY ORDINANCES ,AND STATE LAWS REGULATING �
PI_U M$INU AND SEW Efts CESSPOOL Q DRYW ELL
I
HERF.y CERTIFY THAT i :IRM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR
LJCENSEf� .A5 REQLitR£D BY 'OS ANGLES COt.INTY AND STATE OF SEWAGE DISPOSAL SYSTEM
CALIFORNIA OR THAT I AM ,fFE
LEG
OW NER�F,r.A ND INTEND TO DISCONNECT PLUG AND
RESIDE IN, THE A80' jD ORIBED PESIDENV- PRDPERTY. / D G
k� ABANDON HOUSE.SEWER
SIGNATURE $AC-1IL! SEPTIC.TANxS ❑ __..I— ___._._- _—. _—_—_ _
OF PERF!TTTEE ;>� -
SEEP,FIT I'S1 [.� CESSPOOLS
VALIDATION ROBERT A. WOOD
Cx;' M.o. CASH
SUPERVISING MECHANICAL ENGINEER