HomeMy Public PortalAbout9020-9022-9022 1/2-9024-9026-9028 RANCHO REAL RD_Grading_1971-05-09 APPLICATION FOR; GRADING PERMIT
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COUNTY OF LOS ANGELES ADDRESS 'VLf/76/ '�. l- R-Oh-0
DEPARTMENT OF COUNTY ENGINEER
B-UILDING AND SAFETY DIVISION -� cd 6
LOCALITY
FOR APPLICANT TO FILL/ IN CROSS ST.
AIDDRESS ���--g�� "'�LL�t F ILO Re4-I DISTRICT NO. MAP NO. STATE HWY. PROCESSED BY
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NUMBERS _ BLOCK USE ZONE SPECIAL
TRACT CONDITIONS
NUMBER
OWNER w�/' • V 1I]YY+ ��V�r Gr�j
MAIL+x / J� �� j3 , ���)r DATE AGENCIES REQUIRING CLEARANCE
ADDRESS
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CITY '�I{%'/V1,1�'''�+d7/gy �yNOL' �y7��JtG�
ENGINEER 00(( Vr1�;M :IN�'�+a. RE�(G/TNO. jg7-//ry�
ADDRESS
CITY ,,,A,�42ri5N' AjJOLl-Nvz _}1/"9ffAe 5g
GRADING .�'i IS 9:`�f TEL.
CONTRACTORi,{ !!11 [V/�y/ - NO..
ADDRESS
BONDTY $ OND
PROPOSED USE OF GRADED SITE(S) COMPANY
E�� ++�alt�andb�7dl�l i11�t�� DALED RECD.
BY
CASH RECD. DATE
DEPOSIT $ BY FILED p.
CHECK IF SUP V SED GRADING
SIGNATURE THIS IS A LIMITED TIME PERMIT Z
OF APPLI�CA T ate' ALL WORK AUTHORIZED MUSeT BE COMPLETED BY
ADDRESS MAC-1 ,� NOL' a y%•37 TIME LIMIT'
CUBIC YDS. 1 �g I FEE $ 3 s�
HANDLED: L�V ' � EXTENDED TO; BY:
FEE 6, w EXTENDED TO: BY:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS INITIAL DATE INSPECTOR'S SIGNATURE
APPLICATION AND STATE THAT THE ABOVE IS GRD. PREP. y� '
CORRECT•AND AGREE TO COMPLY WITH ALL COUNTY
ORDINANCES AND STATE LAWS REG U TING EXCA- COMPACTION
. VATING AND GR D NG. REPORT RECD. +s+a� .,
SUP. ENGR'S. Jr�`�O�•• '~' y-,� '.jam"
SIGNATURE OF } r ' CERT.. RECD.
PERMITTEE Y ROUGH.GRADING + -
! �/{� d= [APPROVAL
ROVALAGENT FOR d'&-ftoo`� L• . NG ND -r py / NGR'S.~�-eyl�� fj•4r,CIIrjCERT.ADDRESS MAKE CHECKS PAYABLE TO:
Y BONDHARVEY T. BRANDT, COUNTY ENGINEER SED
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PL CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. CASH
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