HomeMy Public PortalAbout10708 ARROWOOD ST_Sewer_4/1/1953_5335-41S sewer connection EDEPAI .rMENT OF COUNTY ENGISrEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
FOR APPLICANT TO FILL IN LOCALITYBUILDI
NEAREST
ADDRESS 10708 Arrowood St o I CROSS ST.
LOCALITY El Monte DISTRICT�N)O. SERIAL NO. Q�PERtMIITT NO. C
NEARESTEl Monte o1�J/ A ��i �r9��1 "�� J
CROSS ST.
RECEIYEO B Ready for Inspection DATE ISSUED
OWNER PoLo MONUtt �/v.$Z3
MAIL ADDRESS 27 "'';; a1,�al $I Td USEp20NE OCCUPANCY BK MAP PG
CITY sSaS Gab_r_ielTEL.NO.AT 94364
CONTRACTOR LoDo& M. CONSTRUCTION CO, CO.IMP.NO.
ADDRESS 408 Winthrop Dro - .' JOB NO.
4sa �
CITY Alhambra TEL-NO. AT 48315 TRUNK PERMIT NO.
STATE
REGISTRATION NO. .113613 C 42 p COUNTY' ROAD PERMIT NO.
LEGAL 41 STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT NO.
BLOCK TRACT 17867 INDUSTRIAL
WASTE APPROVAL .
SIZE GF LOT N0.OF BLDGS.
NOW ON LOT2`. CHARGES
USE OF
BUILDINGS 1 Re so CONNECTION CHARGE FEE ,
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT�FEE \
1 PUBLICSEWER @ $ 3.50
RECEIPT N0. DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING a '' DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA v
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 �i ®� / MAjNHOLE
UPPER REFERENCER�
aY-1— OF CN JU31 I;O NP.L.�- M,.L T:O=P?L.LFAGTWFRO "
OWNERS PERMIT $ 1 00
AUTHORIZATION TOTAL FEE
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER )
SIGNED THIS--------------------DAY OF........................................19NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT------------------------•----`---------.-_........................---•--•••.. BUILDING OR WORK
ADDRESS-------------------------------------------------------------------------------------------- SEPTIC TANK,SEEP.PIT(S)
AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL ElDRYWELL E
CATION 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 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E]
SEEP.PIT(S)E] CESSPOOLS
SIGNATURE
OF PERMITTEE--- M-
— - -•- •�-�-•-.•--•---•-•-=-�++--•----
76A642D 663 1/53