Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
1105A
� . 76A641� � CE fl08'RF.V.6!?f3'1 1:79 ��������°�°��� ��� ����� �� a; m '�--.�' �1/�EF� - S��l�l.C� I31��'�SAL C�3UPVTV OF�,AS AhlGELES ��31L[�9RlG AND SAFETY FOR!lPPL6CANT TO�9LL BN T °15TZi:-"° GFO1 F �GP �'�nCE55_0 6Y / e�l AG BUILOING.�/�//f � n w ,� ,p� �nJ J/,� f y�� ADDRESS_.l.__Sr:.�—� c . _L�G�'�L.—�_':rr'�.• I� y�� .f�+���� � ) � // _�Z",�?���t3MhlEGi'I�Id DAT/� LOCALIT`/ �Y /67 !//���,� F�-lJ�.s� �'_ NEAREST —�J� ""_---- STA?70N �,.A-�,�� DEPYFi y CRO55 5T. �. (Y /S'Y _� �^ �r�- — �--aLrd7 /__"— —' /�J-' "—'- "- � A UPPER /,(/ � MANHOLE REF-EFtE�NCE - «�, � R OWNER/ ,f, �f� /�{ � ----- - -+�.++-__.��"----'�+�-0--�-'— -- ��'--�--'-,����'� TVPEOFCONIVECTION MAlL Jj LENGTI-I FROM ADDRESS Z���C� �,}� Y. "____ CL!RA L_ __ M.I_.TO P.L. � ���w�_S3.�f.ZILU�_ l : _ '_ —__.__'� P.C.NO. // �� � /�{ "L�'"�JX y, �}��J yj1 CO.IMP.NO. JOG NO. �u(��� CI? "l�-�4.+sc-.y�.-e"se-� TE!_.NO. �� [W J�V ""-L_-- _____'__'____ _ � _ LEGAL TF7UNK PERMI(NO. ROA�PERMIT NO. OESCftI?TIO!k LOTNO, �'�'� / AFFID4VIT ;yp�•�;:Fi FASF�.4E�- RECORD.INSTR.NO. DATE BLOCIC TRACT��C7� NO.O BLDGS --'—'- — L—'--- SIZE OF LOT NO�N ON LOT HWY.OR 5'!'W!DEf41NG USE OF � _ BUILDINGS STATE:MCROAC.FlMENT —__ __ F'ERMITNC. CONTRACTOR _� _��/ �"--a,f ✓t ._ �NDUSTRIAL �er 'slwil✓ WASTF APPROVAL. ADDRE55�1���._ �P.. __ ��,�� ____' CHARGES CITY , TEL NO.�-•S '� CONNECTION C.NARGE�EE �f -��-------�-�'f_�_.�d --- — ,�. STATF. :o „� uC. / FEIMBURSrM:NTFEE � iCL. LICER�SE NO. � � CLAS i („ �-c - —^— No. DESCRIPTION O MORK ��� �.� ---"—•py—: —�y�-g$E c— �! � �'-'---'-----'_'-'—"'.� ',.."-"" F9r��'�/gd�1Ly DATE IIVS OR'S IGNATURE F10USF SGWFRGONNECTING TO � ///��� � PUBLIC SEWF.R �� �r�r ` -- .-- _-�� �� —}----Z-�-'-�---- NENl HC:USE SEYbER _� , l SEAYICTRiJK.SEEPAGE PITOR � PITS ANDiOR DRAINFISLD ____ _ GONNECT AbL�ITIONAt_ }10USE SE`MER CONNECTING 70 BUIL171NG Of1`NORK I �4a �RIVA7E C15FOSAL S`lSTEM ---�----�- ,� CONNECT ADDiTIONAL BLDG.OR ' SEPTIC TA"1K.SEEP.PIT(51 WOR9(TOli0U5E5EWER ANL�iOFiDf2A1NFlEl.D _L _ � OVERFLOW SEEPAGE PlT.C]RAINFIEL.D CESSPOOI DRYWEI_L ri �XTN.GE'_�S>�OOL,DRVWELL.MAN}{OI..E -- ALTER.REPAIRORABANDONHCUSE � p,LTF.R,REPAIR SE4NFROR� ;iFN/EP.OR D�SPOSAL SYSTEM _ _ Sc4YAGE DlSPqSAL SYSTEM OISCONNE�T PLUfr AfVD —'— --- - ABP.NDON HOUSE SF_WER ' HAGKF�I.LSFFTICI"ANKS .d-._ L� SF.EP.1=1T;51_; CL_iSnOOLS� ��'PdER'S Permit s W t',f�'` - -- ��r�o�€ae���ora aoral��� �-- �'!� �.��i�arioN I hAVE AT 7M15 DATE A CONTRACT WITH 1-FIE HEREINY AMED CON- TRACTOR TO CONNECT YHE A60VE DFSCRiBED[X�STIhG�WELLING TOTHE PUBLIC SE�WyEl�2J. � '— 5!GNEDTHIS� _--F]AY 6F���� _ �� %: j ' {;.+.: !�'y �79_ OWf�ER OR � " C OWNERSAGENT_ /� , 9��� ` _ „ , �j ADORE55___ _ .,-1�NG�=--�.�C, _ 1 HER�BV ACKNOWLEOGE THA7 I HAVE READ THIS APPLICATION a f � Z, '\' AND STATE THA7?HE ABOVE IS CORRECT AND AGREE 70 i OM°P�Y W1TH aL_ COUN7Y ORDINAI4CE5 ANLI 5'A7E LAWS REGI:I_ATING 4 !� � - i, '. P!UMSING ANDSEWERS. � � � '-� I HEREB`; CEf7TIFY THAT I .4M PROPERLV REGIS?FRF_❑ AND/oR IICENSEO AS RFQUIREfJ BV LOS ANGELE i COUNTV AMD STA7E OF ; 1, l�' � �ALIrORN1A OR FHAT 1 AM THE LEGAL OWNER OF.APID!NTEND 70 RE- � W�' �-- iIOF IfV.THE AOCVE DESCRI�ED RESIDENTIAL PROPERTV. :IGNATl1RE ' ,J' � OF PERMITTEE _����/r.G./F� '_� ?e"e'�-".�'.. . .,._ .... �... _. ... . ._ ���?����;���s'�m�T���' .,.��:,.*;�,.�'.^k•�,oa:• .-* `.i •,c.,tl,. >y''s y,x..<?��:C;`:'r s�4a;^..:a?.i�.;�Y'ie' ti 7 �^�UI.LAY: �a,f,.�. 15J11_I��!I.i;%.�) �:\; f"+C��`Ll\I�i. 4"__._._.__'_"'_�'__"'__'_�.."""_..'_'".—��r__._r.���� n� �r– -r.. ;�n�:-i n qC��,�:^� ^C�nl��,i w I- R���7C � L. ��a�.iiL.H i�. . � u :_"s:�'t.c_: ..���V J;_•.ve-,:.�:. �_i: v..ar��.. � `,aY`,.�i;'7',�i �",�l�-? �!: i.�i{: }".1�.`:�.t�� �f.� ��i:.tl=:�'I��:s'.� � r.�::i�`�:3'��:��?�s.�i'.!�.J. , � , � : • , w . . , ,� ,•«.; ;i'.,J a�.. �i'��,�IC.r'?5�:. i�]:!' ��' CC�I!+�.,�!=-1.i�J:' -✓:�,:�..'}a �..�i�.Cr'I�- � .... : .. . _� �.. � . 4�:u�����E -:;�����.�.��,,:,��,�:;�.,;_:��. ; _ .. ,, <: � , C-/ �r4 � A.. " ; �l. =1"..:';l..ii�.=`*�aKl�"� �'.i�4.l..�i'•.J�'i�)�1�. �i_l1�. s � �. _... ... ., �w... � , _ . ... ,. �. � -r r^;'ri� i_",^ r^�^, �.i���. j ' . , . . „ ' . . .. � S. ��^l;�I C..I�-i i�C5�<•:t'3:^i�:�:t_1,.�i�\..�,.i,� � .. j ' . _ . ., i ` � � . ,r�.�,.p � I S � � y .. r � � �. , , , , .,�. . .. .� y x.. ':.; � . a `�4 � � , ' ' . i �.. � .�.. .�;_ .. ' � i $ �. i.-v.e.,.�..a.............».,.,..,.a�m...,......P.....,..�..�....>.......s..� _ .,1 �T, �dE£.EY.�?�+`�` s-I�L'���l�'?T�:__.._� _.� ��__—��.._.�_ _._._...__._.�_..._.__._,.._.�._._ ____��___.._�..,.,