Loading...
HomeMy WebLinkAbout1653A . . _,. . ._. _ _ ...,. __ _ . � _ _ �. _ ,. � vz-000a��w : �_'-r i�'- * .. � � � 4 c.�, ' � ;:F �.r., '.� � .`°WC3RKERS `C°OjJiPENSA11t�N aEC`LA�k�TI�N �� � ' � � - ` « .., -�Pol crt fN�d:cop�tMi oCQSecan9b�;'L C co0sent to'self� ",`:` a�ay . . :. . �. , t� . I kere6y affirm thot I havC a cert�ficate o� . �bA�n2A . . - � � i�- .. vPsure or a ce t fimte of Wo kCrs'CompensptPon Insurance or , �E 9oe�� �� /� r/�� - , ,...,,.,.�.._„ .„.,..,,,,„..,�„„,,..>„, �,S � � ' � � ' .. /'�����d/�1���,���� .. . . . . , `,. Y �� p Y.,. .,�,.� `• �� � .. . . . ;�Cerhfied m is h�;:. . .,.. . . .r. ........_ .... , �: ... � ... , . , ..� , ��: �r j�g �c �^ . .... ..�:-. . ....,.. .._ . � py e�e6y furnished �� � �. - �EWER �J �Jyfr;;�� �7�L. , _ �w� � � , ;�Certif ed mpy s filed wu7i iha,co�nry bui ._.tion '� . , .. '-' C���YY���.�����sE� � ""'._ ..,....� .��VIL��FI�{I�CSy$��'Y�.__....k„� i., ,.�.,,�,_ ...� _..,..:_.. .,. , p ... .. ,_.�,- ,.._ . . �. . _ .. , .. ,`L, . fd ng nspec , '- c{e�sortmenf . :` -; � . .. -t" s e°, ,-Da�e`�.=., e�.�Appliwm . � . . . FQRAPPUCANTTQ��1t,C IKI. , ...` , . :�. �/�9�� ; COMNECTfON�DEIT7�`i'.`..� " '�". .. ... V �. CERTI�i�CATE�tS�`fX�M�7Idi�ROAY��'J�7#I�E �.,: ,. euiioiNG� ... . . .. ��. �.. COMAEt�5A�C3�("I'MS�1R`A�CE " nooxess _ srnri4N '.�".�- oevrH � :�(ihis section need noibe completec��the work nvo�ved`�iy't{�e' �� ' i�A�iTY. �-�. � �� iVwNHo�eaeFEeentce . /�� � u°��R �:pe'rmit isfor one hondred dolfars($100)or fess� ,.; NEaaesr�� , '"" ' "'�� ` � '� ' "` '�"� ' "��- ' ivae�oFcorur�crionl'�"""""' " �- o .., ,i�-: aw� < <.�.,tt K..�-.. . IENGTHtRdAA.�. . ...,.,__. -�1 ceify�ihat in the parformance':'of t�e wo�k{or w}uc�,;}his Cao55-5r. : v. ' Cuae, , a. � Mt iOP'.L'. �- :,-pe`rmu is issued 1 sholl not employ any�erson in any manner � - . . � . - � � �so a to bxcome sub'ect to 1he Workers Com�ensation Laws. . � �-P.�.�o -�'-'7'/r � � � � $ , �, P. � OWNER - CO tMF NO �� ,JO6 P70 lLr� , �, ., . � . a1.'` ✓�, =r . . MAII ' ' � . TRUhK PERMrt NO �.". ROAP PERMIi"NO:. . n6�RES5 .Date ApP!mM �Y �' "�� � .-6� ' � . . . . � S'" ''"°'"" " AFFIDAVR . WAIVER EASEMENT RECtlRD INSTR`ni0:�� DATE-� ' �NOTIC��l'��aP�7C`�S�'li``if Q�t�r:making'iFiis '�,'ert�icate of " - c�n, zE��:�N yr�; ;tom�l� with s�h rovi5ions or(h s�6�ed_,lo ihe Worl�ers' ��,A� -� � -.-- � .�� Ezem tiQn, ou shou}d hecome= � C m easation� rovisions of ihe La6or code,you must focrfiwitb p¢SCgiprip�, " �OL NO - � t p Y p -' „ - . H`NY OR ST WIDEN�NG � - . � �' is perm 1 shali be deemed . . ..:� - � ".�CYOf eCJ , _., � _ _ BLOCK�,' "RP.CY� �'�� STA7E ENCROACHMQJT ��-� . ,� �' ' ^&'� '..w^"..`..':k ' , PERMIT NO ' . � �LIC�NSED C��NTR'�AC7�F'S D�C�L'%�11��f0� '� _ Cp.oF eib�s . .. si2[oF tor NOw'bi�!'LOY ��I hereby af�irm ihat 1 am Gcensed'unde pro�js ons of C�apter , usepF,:�, - r r +�'� � .. 'A(tammencing witK Secf on�7�00'bj of Divisori 3�oi`the�Bus sm�aiN�s- ' � - cr+azces''� � �� , .�,'��ss o,nd Profess ons Code,qn�-my license�is�.in f�l�force:and . . ����� �- � . . ,CfFeC) �� -� yp� CONTRALTOR ' CONNECTIONGHARGEFEE � - � LlG8n58 NUr�6Bf���� Li[CIp55� �V�� E+"� �� � . � REIMBURSEMEM FEf _�, , -O.� � . . -�---.----�--- A9DRE55... �COnffOCfOf��C3l��� �I te � ��� (�� . 1 ���� /� p �L �DIS7RIC?NO � 6ROUP MAP ..._ ._pROCESSEDBV:..... SJ ., .. CITY ; ' TEL NO �I��✓r'"�7 � �. ..r--r-� , STAiE ' JG. �.. �i^, . � �-3 � � u PlumbS�n Codeandsor�ec ., of7heL of he ..y� N�ry�. HouSEb� k���� c�� �e � �� ��� � : � �g .. , ,a',�.,� ¢ .o,a_� � `�. �vriC rnNK,�ON OF WORK� P�' � FiNai . " _ . U _„�. Necnwc ro.. ._. .,� _ .�'j onTe VACIDAT16T�1 ." w B &P.�oda 1or e following��eoson _ PuB ie 56WR �" ' ` __ �� ,a�--. �� � DOt �� � PITSAND%ORDRA'117�1��OR �'` ` ..��"`.' BIYAt , -.�. .. �. - � . NOUSE SE'NER COHNFfT NG LO �. � � ' PRIVATE DISPOSALTYSTEM " ' � S19nOtU� � � ' � CONN T A�ITIOIJA BIDG OR.. " . .- , .. . . . . . '' OWNEf{��UILY3ER`LS�T"�`11�A�YI`O'N"`° WORK�25H�CYS'�SEW�a ' ,�. . � ' .r^'." "r•^^�•"�^-n- s.�- ',wn : `., .. OVERFIOWSEE7pGEP1T DRAtNFlEL6 -' _, ,I hereby affirm thot I am exempt from ihe�`ontracts�r s icense exTN.'c`E5S7odi;'pxS'wE«,h�nryrrblp ' -� - � - � � -� � - � � ",.,Law fqr the{qllowing reason(Seclon 7�31 5;"0u'sne's's ond�;Pro- � ' �urea,aeaAla�taaawooW"(iopSE � : � � .f}e-s-�s ons Code)• . - sewez ok oiseos�i si�St�µ"'"�- � �� � � � � �� '�J I,as owner of the ro er ..� � � ,. � ...�� � . � . . -� . . . � . " .. -��..�J.3.R.. . . p p ry,or my employees with wages as .�.� m.,.�.,� 'their sole compe�sation,wifl do the work and iHe strucfure - � . - �� . � '�. is nof`nfended or�offered forsale(5ecto.n 7b4`S 6us'ine`ss �'��` ��- `-�". , � . . , .�. . � and Professians Code). OWNER'S Permit $ ��� �Q � ��� a a G-7=J.('i �. . � . -[�I as owner of the prope ry am'�exclusrvely�'cootracting with - AUT�'f.0'�I�TI�(f`� TOTAL FEEY �TT-� • - . .. �. ' � m �r..'v.�r�� .; �� I censed contractors ia mns�ru:ct the pro�ect(Seof on 7DdA�us, "Au i HAyE � � � -�_ � '� Ai,iH15 OAtF`.4^COTI7R7CCi"W1tH'LN�F1EYiEN'�dEp C6NTRL,C70R'io � � Bus ness anc1 P of�sgians C,`ode)� � coNNecc�rHe naovE oescR eeo enis�rrviGen��.r�weCu�c r6�THe auee�Cs�q,�a ' '� - - �.t�,2 E_�R�� ; c�Nsrkr�tYror�Y�N�iNc a��N"cY *g �p Q,. � '�"'"' a " � � SIGNE�,7HIS �J DNYDF �✓��� ',9,§�„�� � i herbby affirm�fha't t�ier9 is q conshuct�on��en mg agenCy � qy�NEROR � 'for the performante��:of ihe work for whicF ihis permit �s � � pwnlexs�ti ' - '.i"s,sued(Se't..309Y,�r'v,_C�'..,...,-.,._.....� .a„��,._�.w...,-. . . . - . . _ � ' �.1 `,. .�V .:. �v � ,. ���?- � �' , 3 ADDRE95� � ._ . l,ender s Nome � � -� � . ."' : '-r '> ,2 " �� ze�:: ��a:Y.�� . _. ' '.Lender s Atldress '' �" " � � � �� �� .. , - , ,., . _G_ . .�.: ... .. ...z ,.�`�` � .;� ,.`� . �.:. . .,. '.:': '.'_.�� ... . ':,. . �.r. .. .�,:... �. �.... . . . . _: . :,:�,.. , � :. � . : .. ., . ��a6o e nfoSmat`ron srorrect.I�agrelimtion an'sl stpte that�the ` � . � � . � -� � c iif tfibt I have.read ihis app � e fo tomply.wrth pll Counfy � �' . .` . . . . . .. . . � ordi ances and State laws regulqtinq Plumbing and Sewers. . - ". ' ..... .�..., . . . ..��., ,. .�.. . ..,_.._ _.. .. . ,._,.�v . . ._. .. . ...., . . ..�. . . �:art hereby auihor ze�.repreSentatives of this County to enfer � � - � � .0 p ihe p6 men e� property for inspetiron purpose5 ^ � " � �� �' �� - � ~ ?r > � � .,,.,.5ign�erC�... '�a"te,�—.,.. ..-. .„, �-�. SEE��i3'E�'$�f`E5�!'�S��Y`AY$'Tt'��"L'"'Il"�rL'�''t)'A'�'."" ..e......,_.:..y;-.�....._..>,,....:,.�.:..a.«V,::._<u.u.,�,,.u..::::.,,..,�.,.,.v_�....... ........:.. ......�..:..w:,:.:v.:; ( „; . . . s,, ,, �� �'` ; k '��"�ds�€�ss�s e�oi�� ��`9N���:1DE&213�CL9.II��I`�C31�T . � L . ..,--;r:.---`-�a:�a�";r� .„.. .,. ..,...... , �r . a, �b .. ...:, ,,�,�. _t_.,,,. „ .... , ,,�.e. , ,,, ,,, ,,,,, , - APPRO�19Ai.3.� oar� �� iuscEcrort-'s sicNaniae... . . ._ ,...�..� .- . . �-� ..�. -�� I hereby,r�iiecn:x5eat I am excaigax feam xhe CBafracto�'s_� . � . — .�..—•�_ � . ... .., ,. . ..,�.�,iseuse�';aav'for�zh�-:#ce3iowing rePascrsa/Secteon 703:i.$,” NEW FIOJSESEWER. ��� ,. . . . .. . ,.:�: � �,.,., .w��»- .: .$M3�4a¢c5 4.ilt„�9'6f23Si6T.,S L'o6A¢J: As.y 4'Edy��oS Co96aaEy. . _.._ . , .,. . ...+�s*. ...._.�. _�_..____ .�. . _:'.=_ . . . . NNNKT ADDITiONAt , : '.. . �� . ,�.� . ;°. �. '-� ��zUI9iCIs(�RWes a.perr�sB,80,coass3rncC,,alter„sm$rroue,-� � aurtorn�oawoxK `� .".�. �. � . '.. , -. olze& mr sr- � s or � iss xee � —,.,..,....._....___:� -dem v�p�, amry �ructusr em aPs raa , 'SEPTICTANX�SEEP.PI'f(5j . � -._.— �"'_Tw, .,-..; +va .,,.+; . ,�re:� ,..^...,,,.�.- ¢ . . . -.... Y"..._. y . . �. � AND/OR DRAINFIELO ,. ��. ,.-.. . ...: : 4,�.` � , o.:..•, ..6F50 P¢ff'JS/'B$ ii�f'QY�YaCfl98 .gO�Si46�J fbBffM�Ly$d,�SC6'R- . .. --- . �",-. .�. � �.., .:�.., �:��. •,. . n e�l ssctesrzeeas'tb¢�be a. tir.asar=gd ursizaas: aa sA�.. .�. ..�.__ , _.s.._:..., _ . _ .., .... _. �. '. ,.,�,xv,......�°.,. ...� . ;_�. ..,,..<.�_�. P c'�s5e:xvt�. oavwfl.i p . . ...�. . ..�. ... `--�—=t--= ..---- -`=�r—�� � provasao�a:s af'Sbe'�osatinceors�:,s"cs�se"�uw(�bctpaer 9: � . ,uTea peraou,seiu�B.oA",._._.,�, : � ..:.. . ._ ` --�:��.-�-a- ,> 9us£nase w�uP'IareJ"essiasu C`odeJ 1�%huuxow�of a'SQ; sEwnc�oisaosnc svsr�ra � ��� � �,�.��-- ..,.'vdada''tson oj',Fec�teose�7031.5`b 0���tbat bs�'+s sa-�inp:�. � ��scotiNecr'rtUc arWo .,, ' '.- -' ., .`.. .. . .- � . _. ' .therejroea eaarz s$se basis J`nr¢ne a{Zeged rxgaei�kamaa'i4zay'.. ABANDON HOUSE SEWER � . .: ' " . R 4br''OT 6 2 �$ . '.�CxFItlSEPTiE7ATJ1( Q, , _��:.. .��..., ... :, ... 3° f p . . ._.... . . , f �° pfI eCtR P'�dE.. �. sEev,wt s C� cFuvoous❑ .� . . . . ,.. . �.� . ��� �.� � saBfacas Sbe a�rlscc�st ev a ci vi3 pereaaPBy f not rr�ose thasva . ._... __,. _.:...r _.._ - �...,..�_,..»,M..,»��v "�''---��--'*�-m. 1 .v. „... .,��ba�ecl.Pea da:tara j.6soo1.. � .-. ._ ,. . . . --.�..�..�_ �.. .. . . ��� � ' �;. ., ,':�. ., , �� . . � ,`�- : g 4 �" x ��.,� Y,as t3�e omuee�ff 21ne gmper�crn44 do eFie�urk,ar.c'. � ; . :: � ." -, , , - ��;","' '"�" � ;' he s' ' -�'i is aot imten 'z offesA t � - ,: ,:: .�..c .._ ._:.. , . :. _, ,� . . 't te�ac[v e ,.. d�d u.-.. d of aLr ." _ _ :___. '�,a . -: �. �.�,. . . <,,, �.: .. �._ y ��' � -� . '°%s 7944,�uamess��acd ProjesFd�ns�ode?'1"be Cuv�� : .. .,. ._..., �.�-�-.�.,.�^.µ•�a;r� ra`c2'oi'a�:scem"se"l.aw�u'a�a^.uil��ap!y tu oa os,raer o,f�. : . W_.. _ :; _. .� .' � -�� .. "',"`"".�..�" �-.,, sw�b�wnr�Ysn bw��r�d� t��ea� �p^��naenPa. ... t '� . � ... � . .; .,: � . .�: . ' . ., . . .� .�� , � -�rare:boi¢stteszde�d or'oJje��o�s�ie boiv�,ar 36e' .._._ .. ... . <, ._ __ - , . ....,�.. .� � �, �._. . ,. . . -.. . � . . , ._... _ ,.� , .�; �^--' ."�ae�"L�"a"g`'db'e�a�v�snF ss so7�sr,i¢Sso�pt?� ed��mf�. . :.... � _: .-_:. __: - � .'- :� - . . 'j� -, .� ..: . , a+.F - t �� �:.. ..a ��'`caanplaLiou, tba owse�es�ltufldes^-aontd��imve��be batxdev,s . � o „ � .:. � _ -,:� `� �C" .�pr.ir,aprove por zb�' ____ .�. __..„ � _ ° �._,a�. "` � �ov' baa he��at�ttdkp . >. . - ,� .� � of nIe) , - . , _ _ �ose _ , , - '-- - � ti_ +.r w ,'��-- �a m �.* ,� � ���371fl+'1.���➢t elIDt��Y'��C"'��- � � � . .�. - ..k� f bY 6., k 4� .. .�.u,.� n�. -�..�a m+.,,.:z H�.c+..,. . . . � ., �_ � , , � - , ., .� . ; � . , �. ,.'. L;� .. . , ...... � . - ... : ,.._., ,.,_._. . ..._ . _ . ... . Ii&Pe� fai Rkiis teaS(YII ..,_ , ._, _. _ , „ ,_ �, � _.. .._. ��., .. � � ti � � . �.�.� _,r _ ; . . � x _. ;�� �. -. n� ,�.� �_ �� _.__�;. �.�.._.,._�_ , � ..�:. «.,.�,;,, h, �.,,..... 13a34e ' .,, ;;.��»,. � f)wner ,_ _ . „ - t� �,�,;;. ,,, ., .-� ,.. _,.:w �,..�._.�. �,.,.,...� ,�,.�.�.�,»,_.�...,:;w-�,-, _ , , . � _ ., .��.�p.,� ��,k.,��w.,�F.�.�.���� , +�� � , .� �i�9S5�EL4�R'S M9AiES -. .. .. . ... .... .. v � ,, . .�.,,.._m,.M.„,_ .rt..: -:-�-..Y.,y�+•. ..�r... ��. . . .,;: . . . . . .�.,.�..-m--,—.. _... : ,�........,. a„..y..�,.,;.�.....4w,..��.: .,..,,x�«.,� ..�.�..r.,��,�.,:�.�a�.e��-... .....- �:�-��-�,M, � :� .� � . 4'.. � .. , ;- �_' - � ,. ..: ... ......... .. .......... .v,.........._�..� . :.. , e � ,.. �-� ... ;��'. � �s_ � ..: � ... , _ . .w.�T�:.,"'r= y��c..;�;"....�." . ..� .. . . . . ,., . � , .. . . .. .' . .,:� .. , . -� . � . ., ...._... .._..»..,.�.,�......_r�......:�u,* r��+-Fcw�, �' �r� .w*�ws4�s�*<.� ,a{...q, .. .' � , ��a ��� . . .. ; , ... .. . . ,� ...._......�.,�._..� ..,w .. .. ... . �.� . ..,. -..-n+Yw.�..,p.4.-,.ci�yoqw^n+N+�.,'hr� �.. °�^!i'. . �_�.,.d'nrt�.�s�xa.twdsw^.�,=c�a...�"i�',�r.aY` . � �n�A'� �;A++"� y.t �.'��, -C' "'� ' . ,-.- „ .,,- _ ;. . . .. �.. . .. , � �� � � . . �'�es.,. .. � ' � : . . � ,�j�..�' .� �:i - � v . �„�Y �,.'a.4't � .� .n �}.'�.. x`e,,,.1 �,:. . a;:�www«�.siuMi.� . µ , ' � .�. -' .., .. . . , - .. .." ..,........w-«raaw-.^,rm...,.-.-.,w.nY.-- wt,^-....�r.Me w>..F:�»a�'-FSes �a :,'xw �,e�..�-+.- „.,a:.. , ..:;- _.. , . . . .. .. . . .. .:�z. , ,. .�.�. . . .._ _'_.. .... - . . .... .,-... ,,.......... .,.�.,.....,.o-.�..Aa..�w«.......,a,2.,,...m.uy��,%as}��,+Wxeuryar � . tNaRa '��`s::�.a� . . . ... . .. . �...,.� n.. � ..� ..;+ i .. . , ._.-.... ._._.....-a..--.,..wn.+-�..�:r...� �.�.-�^a^.... �w...a .e.w«t:w.w.Y.�'u,o-w:✓', :..vJh`l�`a�:�'i:M�YPie'1E`e.3Lw'mT"+eV-"y'4�d�'"#�'��,'�' _ .� �.�� 3bIX�§idR �t5"I+H �d£pi.'al�.i''�$ . � � . . ' .t'�:,. . .�'.�. . ..a ., .�C.`�]�. � '.1�. _r.3' . � :. .� .i- . .. . . . . ,. = y ; -., . . _, �_ i h .' .� ..� _ .. <.4..... , y.,.....n x+.�...-.. .vn..r.«.e.c:wuwa+�..u.mi��Po�*tr3'�e„ • � -_.. .__ - ._ . , ._': r... .. . _ . .�, . ,� .. . ` �.J2�s�'�N . . - . . . ,..., . -� _. ..... . .,,. , . .. .. e . _ .+,.... . . . �. . . - . . . . � . . _ . .. . .. .. . � . : .�...- , ... . .. ��:;� . . . .. .