HomeMy Public PortalAbout9962 OLIVE ST_Sewer__ C-3,77-Y" A A ... .. ..
96 6-iD APPLICATION FOR F IS"
DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE 'D 1S€ OSAL
Depwtment of Coujity Engineer
County of Los Angeles, BLTILDI G
A�DDRESS �" ..
JON N.A. LA` WE, COUNTY P`I�IGINEEt�
CASSATT!W GRTrFIN, SUPT OF BUILT OING °OC,r}i STY ..5 1'" '•✓ - - - --
NEAREST
FOR APPLICANT TO FILL Ilai �Rvss LEGAL OWNER
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DESCRIPTION LOT N�29 OWNER
WAIL
BLOCK - TRACT
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ALDRESs f
NO OF BLDG$, "
-lI3's';OF LOT d� rti.V Y_.,.; NOW ON L9r.��___.-___..___.__— CITY . . TEL NO.
USE OF DISTRICT NO. GROUP MAP
1FiTILI7 NGs i BK PG
AJ.0RFSS .t., - CONNECTION DA�'.1 -.._....-
e7T'f TEL.NO- f STATION .Yd DEPTH
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ST AT E
REGISTRATION N0. �:,+ r --' (] L u-NTb
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NO f 3ES4RlPT[i?N QF WOR}, EE
-- -- --- ---- ------ -- -_ --, tTYPE CPCONN CONNECTION LENGTH FROM
HOUSE SEYIER CONNECTING 76 I CLi
PAI h' LTO P.L.. -'---
PUBLIC SEWER to s -;_501 .�-
SE°TICTANK SEEPAGE PIT OR
PITS AND/OR DRAiNFIELD r l s"..V9QVER
i FKINF,Cc P01)SEEPAGE
L;uYOePIT,
L,flR"INT=LC -I P G NQ.
y CO I5 ,? J 03
. NO.
HOUSE St ER'CONNECTING TO I
PPIVATE D1SF +SAL SYSTEM f 1.00 I I --TRUNF1 PERMIT NO. ROAD PERMIT NO.
CONNECT ADDITIONAL BLDG OR r STATE FIs CROACHMENT
WORK TC HOUSE SEWER c S Ii 0o I _a•`' �;. 8 PERMIT NO. -
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A' Tr,'x.635 'ai3,OR,AB,kN€�rJ'f+EiGt E rGUSTR AL
SEVER OR DI POSAL SYSTEM. u p 1.c0VdISTn APPROVAL
- - -
-- - - CHARGES
CONNECTION CHARGE FEE -
ow S PERMIT
t! 00
_i,v_ UR9F-ttiLNT FEE -
AUTHOR ATON TOTAL FEE
1 FAVF AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- ____ APPROVALS DATE ISN PE.4TC R S Sri:;tlA liRE
TRACTOR TO CCINLCr TTE ABOVE ELSCrIB fl EKST?NG DWELLING -�
C THE PUBLic NEW HOUSE SFWER
SIGNED THIS- DAY OF-41 !,,, N
d 13 �' CONa CT ADDITIONAL
d
J.::.2 OR �' f ,
�, ,•"' BUILDING OR WORK I
0 YNEWS ACEY'` - - j- -- -
„� 3r-TiCTIN1 SEEP,P3TLS
rk Uul3Eao.._.
_. �' " D
1 h R£ „
1' A >f 1�'L£CGF. THAT HAVE READ TH15 APPL CAI[ON � I
AND STATE 'dHAT THE ABOVE iS CORRECT AND. AGREE TO COv+IPL1. ..ESSFOL�C�i :TRY F4L.�J �
ALL CC N. r G,L,NANCES AND STATE LAWS REGULATING ALTER REPAIR,.yF°rER OR �
p I U,M1 S ipiG AN SLINF.R . SEVIAGE D,SPOSAL SYSTEM
1 i Oft_;D'r rC T F't` C{{AI ( AM PROPERLY REEGIST0 SCO NNE,i'PLUG AND
L,.CENS£D AS P EQUiRED BY LOS ANGELES COUNTY A'D STATE OF-
CALIFORNIA OR THAT I ABANDON HGUSr SE E,ti
94 T LEG(�L, O 9Lr: j.S#'E A - -
DECIES XI OP£ e' BACKFILL SEPTI,--Tfk 4'�a i
S .. 'p EF pl ( ) L 'SSPE6I s J 1 t
t3F PERMITI-E
JOHN A, t_A.MBIE, COUNTY ENGINEER YAL^_I9:ATIOINT ROBERT A.,W000, CHIEF PLIBC. INSPECTOR
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