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HomeMy WebLinkAbout1051A . t. � '�"�::`ax�'� .,,.,�y n� ,�'G,�n.�^�..#.�.'�;" ��a*'�;:� '"� _�m z '� .,�"� �"4°'xr ,, . . .. . . , „ < T a t. , 3,�, . . . ' .. . �� ' ' � . . . . ' . . 9r.ii,.s .. .. �. . .. ,' 76A642D CE808lREV.b!78i , ���� ������A�j�+ . :. . � . . �S AP�''1,..,1�AT`IC)iV �'C�R PIERR01,: �, •, , �s. ,.z4 �„>a _ _ .. _..,. S�WEF� - SE , r� COUNTY OF LOS APIGELES '�°` BUIL�11hiG A:t�D 5AF�`�'Y ,. � +�� �� � � � �����' DISTRICT NO,-� G lIP �- �� MAP .,;; -: PRDCESSED BY' - - � FOR AP�COCANT Td3 FIL9.IN BK �� '� /�,g °"' ADDRESS � �� 1 ✓ � ,��,:� f..+�h �f f„s"� � ��r�w�crooN a,aTA T�� LOCALITY � �� -. Jv . � .. NEAREST / � � STATiON ' �� �. � ' dEPTFi " ' ' . � CROSS ST. J,D,f ,�, . ' � .. . ...�;, .: . ,. ,�,�` � � J �' S'D�� ARANHQLE REF'ERENGE � LOWER OWNER � � �� ' TVPEOFCONNECTION� - ��'��"LENG7N-FFY'bM , MAIL �, j Y. GURB P.l. M L.TQ P.L. ADDRE55 ,� � , . � , , P.C.NO. GTY - I - TEL.NQ. ���r' ...,� • � � GO.IlAP.NO. -JQB NO�.' ��.. .. . LEGAL � � '" 7ftUNKPEFtMITNO. ROAOPEF2MITfVO. DESCRIPTION LOTNO. � ' _ '� ` �f ' ' _ AFFIDAVI7 WA�'VER FASEMENT RECORD.IN5TR.Na. - DATE BLOCK TRAGT �p � NO.bF BLDGS.��. � � � � - -- � � � SIZEOFLOT NOWQN�LOT�� �� HWY.ORST.W�DENING�� � USE OF � � �" � � ' 6UILDIfVGS STAYE ENCRqACHMENT �-�� � � - � � � � PERM IT NQ. - CONTR � � �� � � �Nt?US7RIAL � � - ACTOR ' +*� WpSTE APPROVA4, ADLIRESS `� � t A �„y.�/y� CHARGES GITY . ���L.�^'fP�,,, TEL.NQ. ,���^�� 1 "J �ONNECTION CHARGE FEE G r S7ATE'� ' '� �J r' - L!Q /B � REIMBURSEMENTPBE . � LICEN5E NO. / � CLASS lr�""' � �� .... . . . / � NO. CAESGRIPTION OF WORK ��FEE A�PRAVMLS DATE � INS E r OR'SSIGNATUR {� HOUSE 5EWER GQNNEC7ING Td � � . � PUBLIG56WER ' � - j� � + a - � SEPTIG TANK,SEEPA6E-p1T OR NEW NOUSE SEWER � � �! � H�n .�,�. ,...._.... �. _ , �L PITSAND/ORD'RAINFIELD � CpNNECTAfl�ITIpNAL HOUSE SEWER CONNECTING Tp pUILpING dR iNO1ZN d� - PRIVATE.[Yf5POSfiL SYS7EM � WORKTOTHpU E'SEWER DG,OR - � � � � � 5�P'��CTANK,SEEP.PITIS) � . ,, , ;,,,;,,,,,,,, ... . AND/QR DRAINFIELD, .. . . OVERF40W SEEPPiGE'PIT,DRAlNFIELD GESSPOOL U DRYWELL❑ EXTN.,CE$SPOOL,�DRYWEI,L,MANHOLE ALTER,REPAIR OR,48ANDON HOUSE � ALTER.REPAISt,S�WER OR 5EWER�OR DISPOSACSYSTEM SEVVAGE L315PQSALSVSTEFA ....._..,.. . .:�,�. . .��.:.�..... . ......:......,.,.. . .. . DISG6f+1NECYPLUG�J4�SJP. :.�. ... .... .. ___.. ....,_....�.,._...,:. . , . ABAN�ON H4USESEWER . ......>.. . .....:.:.. .. ...,._:.... . ....,.,.,:....,;,.;.. BAGKFILLSEPTIGTANKS❑ . . . ........ . .. . SEEP,PIT(SI�, C63$POQLS G � OWhIER'S Permit � �"� _.._- — �� , . ; YALtDA71AM ......:, �,.,.,.,. . U. .,r.:,: AUT'HOI�I�AfiION TOTAL FEE "' . "` .�.__��__.�. I HAVE,P4T^a'HIS�DATE�A COIV'1'S`£AGT W17H�TFIE HEI�E(N fYAM6b'CON- . ... ....., . ._.._.... ,.....__, ...:.,.5a i .: �' e� .. . -. . TR4CTQRTO CONNEC7 T E-A'BOVE DESCk16E6�BXISTING DWELLWG � „ � �� .. TpTHEPUBLiCSEW R. • , - p � � SIGNEDTHIS�... .�-� DAYOF. '` � ..._ 79� . _. .., . .._. . . . ..... .... ...�,..... ,3u�..�, �, '^. '+��.:��1 5.�..,..-.. . OWNEROR � �.� � 0 OWNERSAGENT � - ' �-�� . /) , ,._... .. . ' ' . ,.......,. ... #_,.-; � � .`i`.i)f, ADDRESS__ ilr�'"_+s,_,._,� �� . . I HEREBY AGKNO EDGE THAT I��HAVF_ REAd 7H15 APpCI'CA7iC5'N ' - � ' "�� � ' -" �--"����" "+'�^"��'�" h �"'�'��' " "�':��"�"'.:.. AND STATE THAT THE A60VE IS COktREC7 AND AGRHE TO-COMPLY � � � �' WITH ALL COUNTY ORDINANCES AND STATE LAWS� REGULATING PLUMBWGANOSEWERS. . . .. . . s .... , ...: ..._... . .. . . , ...... .. . ... ... ._. . .,.1.:.:.;� � �.p..a..�:3�. ....... ..... . 1 H�RE9Y CERTIFY THAT i AM PRQPERLY REGI57�RE� ANO/OR � " � LICENSED AS REQUIREp BY�LOS ANGELES GOUNTY AND�STA7E OF . GALIFORNIp OR THAT 1 AM 7HE LEGAL OWNER pF,ANQ INTENDTO RE- , .,,,., ,_,._.__.. ,.. . . ,..,.„ ,._. .: .., ........... .... . SIDEIN,THEF:BOVED�S'CRIBEpRE51DENTIAL�P�.OPEq7Y. -`� �- -' � - � � SIGNATURE .... ��,..,. +, .. -.;. . . . . . .,. . . . . 4 ... .....:.... ...... .....,....w,,,.. ....,...,.. ...,..:�,...,... OFPERMITTEE � '' � " .;�,�,�,�_�, . ..: . .... . ......... . . . . . . . , .. ( /� . . . . „... .. . . . . _ . .. . ' . . . . . . . . . . . . .. ,. _ ,_,.. .. ...... _.._..... I . _. . ..., .. ._.........:. ...... . ... . . .. :. .. . .. .... . .... ._.. . ..., . . .. ..., , ., .. . . ........... ... .......«:m...... ..._...._. .,. .�..«..�. ..... - �.:t.,�a .. _ ._,_._....,,.. ..,,,.�.o.:�:.�n,...�:.:,:,�..��-�:Rs.u,.s..bvn:?�as:..�:ara,ao.e�s< <,,,.n::o-��.*�.,wrmrw�a.=nu,�. '.. '.`.'. F����P�.FTA�E6�BT t35E , , %, �� ����ER�D @8+���6�5+�;��q��d'' �;� , � '� ,� � �. � �„��,..� � �m k„��c , _ . . ,; <.,. a , � a�:a; i 1. IP�.I�IC/-�7E Ai.L BUlLDINGS ON PROPERTY, ,. ,� E�: . �: � ;,-R;t, _ ,.,,. .,, ,. .�., , .,.. 2. !R!DiC,aTE AND DIMENSlON SEWAGE DISf'(�S,4L k�Y � � � " � � : ��,, SYSTENI WIiH TIE DISTAf�CES T� 8U1�DINGS ,- AND PRbPEaTY LiNES. ` .... , , " � " ,;: ,r�<„ •e K, ti �r. -. ; r �' � . . ... ... .. . .. . . ........: . . . . t: � ... . . ... -y .J^w. ;u;.. .t��.c.. .._.. ..,_ , .: , .,:.;. ,� . �� ' - ` ". ;'.;.�. . . . . .:,,. �,;•; � .`. ' 3. fNt�lCATE SIZE OF SEPTlC TANK-DEPTH tJF S�EP- _� ' �.�..�:.� _ _. .: :�� AGE PIT(S)-SiZE OF CESSPOdL(S). � � ,, _� �J, �, ; � t^,� �, ` >�' _. .. .�.... , 4. ftUDICATENURT�-I DIRECTICa(�I ON PLOT. ,, � ,,3�, ;,,_.,Y_.. � �. �..a � � ;,�*..��.�:�,.:°, cw.,`��. ft.:.; �" .:81 .i �. , � ;� �� � ..R�, �, � � ,��„ :,� S. IE�if�1CATE BOTH STREETS IF CORNER. .. � 4' > . _. . � _ _: i ti '.a '`:, � =�- r ,,`;; , ,� , . .._ . � .;.. . .i.�,:.�_. �,d. .x. �-:,....._. _. �.:,.._.a�„�.s�r�..�-" .�,,.e:�..y_..��i. . - : . .:.. . - . ,... ,.�,,... ..::�- �:�+1 �_......._ . ._.. . . � .. � _ .._. ...... ... ,. . �. � ... . ,�.a:: .�,� :.�.;., . .. .. ,.. _... ... .. � , . ._z.�:s � : . . .. , T a=., k �4;� .,., �_ , ,�. .�.,. . ...,. . _ . _. � . _._. . � _ � . _. �4 ' , ^` , �'�M � . ���'�.���.,: �Yx .. :� ; . . �-:.. , . . .. ... � . .. .,. .. . :. ....... ... ...... ......... . . .....�. ......__ ,. . . � : g w � , `h. &'`* , . . _.,._ ... . _. „�{u ..-.,.,r`-<'�, s .,..%�..;.^F +.t.'..1-.�'.. .... .'.� ?+m.,� �s x .. .'. .�'�; �� . � :. � .,.. . ... '� .,. �t. ; . . .�.. . � -. „' � ..,� h y , , �t—�+� 5. .4 S �4_�� 5, �.... . ... ..... .. .�. .... .. ........ . _... . . , . ... _. ,`.ps,+w,�`i 8 Sn.B, A'.... _ �.. _'� .... � ., . . ...,. ....., .:��. ' . . ., .,. .. 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ALLE W , �� • , :.: . . . �, ; _ ., .._ _ ..__. . __. __._. _._ .. _ .__ , ; ., , . _ _.. .. ... � . �., � .�;� ,. ��. , � , ,.1 ' a . _. _.__ _ _ _ , _. _ .�... �:� � . ,, �.. . , �_� __ , ; , _ _, ,. , `v �;. _ _......, _ °_... �... �_.�; ;�,; . , __ ._.... . . ... . _....... .. �. ... ... . ;;; ,, . ... . � X,; ���; ......: ,..�.,'�zT#SY.h$.. . ..., ..v, , ..w �..� 5 � .. . ... . . . . ,,.. , � � _ .. .,. ��� . ,. ..'. �... . .». ::.'. ,:.:., .�: �.., ., — .. , .;:f � - '. ..,. ...,..._.... . , . -�g.':».,":';e , '.'...:-�. �, F1ELD NQTES ,< . ,�.... . �,; << . � :� > G.,;�. �;: r: ;� _ : .. .. , . , � _._ � , � _ � ;'� 4w ;., ,..��� � � tA _ .._. < <:...,,� .....__�__ �; � a � sa r ii a h r` �� i! . . . _ .. _ . , ���.. i o '�. � � � ' � . ` ..'. , .:: ;�.., . ", f�- : _�.._.�_ . '�..I i .. , i: '0. . � r' ::}� .. � , , s :.�u � �c �„ ���