HomeMy Public PortalAbout10669 FREER ST_Sewer__ 76A642
CE806.0 APPLICATION L.ICATION Y OR PEI�10 IT _ -
CE808.8-98
COUNTY-OF LOS ANGELES SEWER—SEWAGE ®0S SAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DMSION L
NG-
-
JOHN A. LAMBIE, County F�gineei SS 1.066 Ee Freer.
CASSATr D. GRIFFIN, Supt of BufldiagITY T T°' El 14Tonte AyE?. '
FOR-APPLICANT TO FILL IN L T
LEGAL, k OWNER- Cheroske
DESCRIPTION LOT N0. 1 2 '
BLOCK A TRACT 11290MAIL
t A DRESSN Ras Ond
NO.OF BLDGS.
SIZE-OF LOT NOW ON LOT. CITY -. Pasadena TEL.NO.
USE OF3 Res. DISTRICT N0. GROUP MAP PROCESSED BY
BUILDINGS
BKPG
S
CONTRACTOR' Square Deal Sewer Service , 6 -•
ADDRESS 2933 Mw,,son Rd. - - - C NNEI__-. DATA
CITY , El Monte TEL.N0. GI 4. 2020 STATION. ,r- DEPTH
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STATE MANHOL FERE'NCE��� UP Rte`
REGISTRATION NO. 12$$70 e COUNTY •
N0. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO t
PUBLIC SEWER (g $8.00 '
SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FROM
PITS AND/OR DRAINFIELD @ $8.00 Y. CURB B.L. M.L.TO P.L. J
OVERFLOW SEEPAGE PIT,DRAINFIELD J '
EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00
HOUSE SEWER CONNECTING TO i P.C.NO.
PRIVATE'DISPOSAL SYSTEM @ $1.00 - CO.IMP.NO. / JOB
CONNECT ADDITIONAL BLDG.OR
a
WORK TO HOUSE SEWER @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO.
a EWER OR DISPOSAL YS7EM HOUSE @ $1.00 STATE ENCROACHMENT
PERMIT NO.
1 Saddle 25 100 INDUSTRIAL
WASTE APPROVAL
CHARGES
OWNER'S PERMIT CONNECTION CHARGE FEE
AUTHORIZATION 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
T0'THE PUBLIC SEWER.
SIGNER THIS DAY OF ig_ NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT- yV7 BUILDING OR WORK
SEPTIC TANK,SEEP,PIT(S)
ADDRESS 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❑
WITH ALL COUNTY ORDINANCES AND STATE'LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM _
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY CLOS ANGELES:COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT 1 AM THE' LEGAL OWNER/OF THEBOVE
DESCRIBED RESIDENTIAL P PERTY. - BACKFILL SEPTIC TANKS❑
SIGNATURE
SEEP. PITS) CESSPOOLS 0
OF PERMITTE
we (OAIIDAT'ON - ROBERT A.WOOD
ct;. M.0. - "69, SUPERYISIN6 MECHANICAL ENGINEER
D
CE803- A PUCATI O \ E FO E R M I. -
eeoe•e-se COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING •
JOHN A. LAMBIE. County Engineer ADDRESS 1066 E. Freer
CASSAIT D. GRIFFIN, Supt of Building LOCALITY Tem 18 C 1t
FOR APPLICANT TO FILL IN NO,,T. El Monte Ave o
LEGAL
DESCRIPTION LOT'NO. 12 OWNER' Chr
eoske
BLOCK A TRACT MAIL
11290 ADDRESS Ra and
NO.OF BLDGS.
SIZE OF LOT NOW ON LOT-' 3 CITY Pasadena TEL.NO.
USE OF
BUILDINGS - RP.S - DISTRICT NO. GRA MA7�_ R CES BY
BK
CONTRACTOR Square Deal Sewer Service r V'
,-i �i
ADDRESS 2933 Maas on Rd* CO ECTION DATA '
CITY El Montle • TEL.NO. GI • -2020 STATION� ru • � j DEPTH
STATE MANHOL FERENC ' UPPE
REGISTRATION N0. ® COUNTY
NO. DESCRIPTION 0 FEE rte.
HOUSE SEWER CONNECTING TO-
PUBLIC SEWER 0 $8.00 -
SEPTIC TANK, SEEPAGE PIT OR TYPE OF CONNECTION LENGTH FRO - ;
PITS AND/OR DRAINFIELD Q $8.00 Y. CURB P M.L.TO P.L.
OVERFLOW,SEEPAGE PIT, DRAINFIELD
EX TN.,CESSPOOL,DRYWELL,MANHOLE Q $2.00 -"
HOUSE SEWER CONNECTING TO C.NO.
PRIVATE DISPOSAL SYSTEM Q $1.00 CO.IMP.NO. JOB NO.
CONNECT ADDITIONAL BLDG,OR'
WORK TO HOUSE SEWER TRUNK PERMIT N0. ROAD PERMIT N0. ,d
$1.00. `J
ALTER, REPAIR OR ABANDON HOUSE STATE ENCROACHMENT
SEWER OR DISPOSAL SYSTEM $1.00 PERMIT NO.
INDUSTRIAL _ -
WASTE APPROVAL
CHARGES
OWNER'S PERMIT $ 2 -roo CONNECTION CHARGE FEE
AUTHORIZATION TOTAL FEE 1,00 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.
SIGNED THIS DAY OF 19_ NEW HOUSE SEWER h-r4 T v;.,
OWNER OR' - _ CONNECT ADDITIONAL
OWNERS AGENT BUILDING OR WORK.
SEPTIC TANK, SEEP,PITS)
ADDRESS AND/OR DRAINFIELD
T HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL❑ DRYWELL❑
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT I AM PROPERLY,REGISTERED 'AND/OR DISCONNECT PLUG,AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEGAL `OWNER 0 THE ABOVE
DESCRIBED RESIDENTIAL PROPE Y. BACKFILL'SEPTIC TANKS❑
SIGNATURE
SEEP.PIT(S) ❑ CESSPOOLS❑
OF PERMITTEE.. Q '
�o /VALIDATION ROBERT A.WOOD,
M.p; Q"It, SUPFRV s1NG MECHANICAL ENGINEER
• 1 't L fJ 'V f.� .v.".>. lo.i r �1 .ca tel,•I /