HomeMy Public PortalAbout10702 ARROWOOD ST_Sewer_4/13/1953_house sewer connection to public sewer DEPAKrMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION!
COUNTY OF LOS ANGEL S
WILLIAM J. FOX, COUNTY ENGBUILDINGINEER I ADDRESS
FOR APPLICANT TO FILL IN LOCALITY (` 01)wow
~ BUILDING NEAREST �
ADDRESS -0702 Arromood St o CROSS ST. .�-
Z, LOCALITY El Monte DISTRICT NO. SERIAL N0. PERMIT NO.
NEAREST El Monte Ageq '
CROSS ST.
RECEIVED BY Ready for Inspection DATEISSUED
OWNER PoLo McNutt
ADDRESS `�rj '� C'3briel algde US,EZONE OCCUPANCY BK MAP PG
CITY San GabrlelTEL.NO. AT 94364 I Eq c
CONTRACTORLoDo & Mo Constr otion Goo
CO.IMP.N0.
ADDRESS 408 Winthrop Dro C
CITY Alhambra TEL:No. AT 48315 10B NO.
TRUNK PERMIT NO.
STATE.
REGISTRATION NO. 113613 C 42 COUNTY ROAD PERMIT NO.
LEGAL
STATE ENCROACHMENT
DESCRIPTION LOT NO.
4� PERMIT N0.
BLOCK TRACT 17867 INDUSTRIAL '\
WASTE APPROVAL
SIZE OF LOT NO.OF BLOTS.
NOW ON LCHARGES
USE OF
BUILDINGS lRes CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEEf \ r
1
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLICSEWER (d E 3.50 RECEIPT�NO. DATE `iBY
HOUSE SEWER CONNECTING TO �F
PRIVATE DISPOSAL SYSTEM 1.00 r
CONNECT ADDITIONAL BLD6.OR E h'- .EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 N0:
ALTER OR REPAIR EXISTING /_. I` DATE I BY
SEWER-OR DISPOSAL SYSTEM 1.00 �^
DISCONNECT AND ABANDON SEWER ,-
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR A
PITS AND/OR DRAINFIELD 2.00 STATION (��19 DEPTH �
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 dMANHOLE REFERENCE
��-A ' UPPER L•OwFR
TYP .OF CONNECTION LENGTH FROM,
OWNERS PERMIT g I oo cURB— P.L. 59.L.TO°P`L
O
AUTHORIZATION I TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE PUBLIC SEWER APPROVALS INSPECTOR'S SIGNATURE DATE
SIGNED THIS--------------------DAY OF......................................_19..._._ NEW HOUSE SEWER
co
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT--------------------------_--.......-_._. ___ BUILDING OR WORK
SEPTIC
ADDRESS.....---....................................... _..........-
. AND/OR DRAINFIELD PIT(S)
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL DRYWELL
CAEl
TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT ABANDON HOPLUG PLUGAND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED.1RESIDENTIAL PROPERTY. I, BACKFILL SEPTIC TANKS
SIGNATUREL;/ �i ✓� y/ SEEP.PIT(S)[:] CESSPOOLS
IS OF PERMITTEE------- _ i'tL=l�1J
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