HomeMy Public PortalAbout10732 ARROWOOD ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF ]LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER I BUILDING q 7 2 A
ADDRESS (� �/ EJ
FOR APPLICANT TO FILL IN LOCALITY Wed d J4
I' BUILDING NEAREST
ADDRESS 10732 A rrowood St o CROSS ST.
LOCALITY El Monte DISTRICT NO. Sr(� ERIAL NO. PERMIT
PERMIT NO. c
S NEAREST 15—
CROSS ST. El Monte Ayeo — A d
RECEIVED BY Ready for Inspection DATEISSUED
OWNER Po Lo McNuttMAIL
ADDRESS 272' San Gabriel Blvd, U ZONE OCCUPANCY BK MAP PG
CITY San GabrielTEL.NO• AT 94364 �
CONTRACTOR Lo Do & Mo Construation- Coo CO.IMP.NO.
ADDRESS 408 Winthrop Dro,
JOB N0.
CITY Alhambra TEL.NO.AT 48315 TRUNK PERMIT N0. ,
STATE
REGISTRATION NO. 113613 C 42 COUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT NO. 37 PERMIT NO.
BLOCK TRACT 7867 INDUSTRIAL
WASTE APPROVAL'S CHARGES -
SIZE OF LOT N0.OF BLDGS_
- NOW ON LOT ],
USE OF l Res 0 1
BUILDINGS CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLICSEWER @ $ 3.50 RECEIPT NO. I DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR =� EXCEPTION RECORDED
WORK TO HOUSESEWER 1.00
ALTER OR REPAIR EXISTING NO•` DATE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA -
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00STATION DEPTH �;•
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 ''� MANHOLE REFERENCE
W. UiF1 Ent & LOWER
�yY,IZE-OF CONNECTION LENGTH FROM-
OWNERS PERMIT $ I 00 CUJiB�` P.L.� Nh13s�TO'PL.
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.......................................I9-._-__ NEW HOUSE SEWER �a
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT----_____-----•-------•--•-•--•-•---------••------- ----•---- BUILDING OR WORK
.-.--_.-_ SEPTIC TANK,SEEP.PIT(S)
ADDRESS------------------------.-..------ °
-----------•-----------...------_...._.....-- AND/OR O R D RA I N F I E L D
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL E] DRYWELL F]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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCO -PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEW ER
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS I]
SEEP.PIT(S)[-] CESSPOOLS Ej
SIGNATURE Z
OFPERMITTEE.-L,_•--------•--==•------..,..---'--•-o-- --•---._...---•-- •-•--
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