HomeMy Public PortalAbout5305 ARDEN DR_Sewer__ 70A642D
CESOO-8-58 APPUCATMN FOR PERMPT
COUNTY OF LOS ANGELES SEWER-SEWAGE DNSPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE. County Engineer
CASSATT D. GRIFFIN, Sup't of Building LOCALITY
'Kv NEAREST
FOR APPLICANT TO FILL IN ___5MSS ST
LEGAL
OWNER
DESCRIPTION LOT NO.
A
X
BLOCK A
TRACT ADRESS'_; 7:t
NO.OF 9LDGS.
SIZE OF LOT NOW ON LOT CITY
77 ef tT L.NO.
USE OF
MAP PR SSED B
DISTRICT NO. -GROUP
A
BUILDINGS Res• .4- 2� E
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BK PG
CONTRACTORonetr.
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Able C
ADDRESS
225 W. Bryant Rd. CO ECTION DATA
CITY El Monte TEL. NO. STATION L4,-(I, DEPTH
G38 6565
STATE
REGISTRATION NO. 168579 COUNTY MANHOLE REFERENCE _�
L/1
N
o. DESCRIPTION OF WORK FEE L HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ $3.00SEPTIC TANK,SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROPITS A D/ORDRAINFIELD @ $3.00 Y. CURB M.L.TO P.L.
OVERFLOW SEEPAGEPITWeLDRAINFIELD
—EXTN.,CESSPOOL,DR._ L,MANHOLE @ $2.00
HOUSE SEWER CONNECTING TOP.C.NO.
PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP.NO:'/ JOB NO.
CONNECT ADDITIONAL BLDG.OR TRUNK PE MIT NO. ROAD PERMIT
WORK TO HOUSE SEWER @ $1.00
ALTER,REDISPOSAL
AIR OR ABANDON HOUSE STATE ENCRO
EWER OR DISPOSAL SYSTEM @ $1.00 PERMIT NO.
INDUSTRIAL
WASTE APPROVAL
CHARGES
4OVM,:, PERMIT $ 2 00
CONNECf'1ON CHARGE FEE
RW'S
AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER, I
SIGNED THIS DAY OFA
ti NEW HOUSE SEWER
19—
CONNECT ADDITIONAL
OWNER OR
OWNERS AGENT 0 r_, BUILDING OR WORK
SEPTIC TANK,SEEP,PITS)
ADORES AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL[] DRYWELL[I
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING r., ALTER, REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
�j I HEREBY CERTIFY THAT A PROPERLY REGISTERED AND/OR
IC I S L M DISCONNECT PLUG AND
LICENSED A REQUIRED BY OS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEGAL OWNEROF THE ABOVE
DESCRIBED R.ESIDEN ROPE TY BACKFILL SEPTIC TANKS[I
SEEP.PIT(S) ❑ CESSPOOLS
y
SIGNATURE
@F1 VALIDATION ROBERT A.WOOD
M.0. CASH SUPERVISING MECHANICAL ENGINEER
7 6 0 1-0 A;-P, 4 5.00