HomeMy Public PortalAbout10726 FREER ST_Sewer__ DEPAIVJrMENT OF-COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEERI BUILDING /����
ADDRESS
FOR..APPLICANT TO FILL IN LOCALITY �/e
BUILDING NEAREST
ADDRESSlO7`ZG FI`AAP qt, CROSS ST. �
LOCALITY El Monte DISTRICT NO. SERIAL NO. PERMIT NO.
CNEAREST
ROSS ST. El MOrit@ Ave o A ,6�0 � S
RECEIVED Y Ready for Inspection DATE ISSUED .
OWNERpo L. McNutt ` w
MAILUSE ZDNE OCCUPANCY MAP
ADDRESS =j San Gabriel Blvd, BK PG
CITY San Gabriel TEL•NOAt 94364
CONTRACTOR L, D, & M, Gonatruotiobi Co.
CO.IMP.N0.
ADDRESS 408 WinthrO= Dr, JOB NO. OE
CITY Alhambra TEL.NO.AT 48315 TRUNK PERMIT NO. .
STATE
REGISTRATION NO.
C — 42, ❑ COUNTY ROAD PERMIT N0. � �--
LEGAL
DESCRIPTION LOT N0. ` STATE ENCROACHMENTPERMIT NO.
BLOCK TRACT 17867 INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
NOW ON LOT CHARGES
USE OF
BUILDINGS 1 ReSO CONNECTION CHABGE.EEE
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE—
'
PUBLICSEWER @ $ 3.50 3 -sb 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
ALTI_fA(R 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 1 z (_
PITS AND/OR DRAINFIELD 2.00 STATION 3T ��J DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 �eOwl d�NUHOLE PPER REFERENCE &
YPE OF CONNECTION A- LENGT
'i
OWNERS PERMIT $ I 00 Y' CuiaB� P.L. M. P.L-��
AUTHORIZATION 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
OWNER OR CONNECT ADDITIONAL
OWN ERS AGENT.............................................................................. BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS...............-......-..........--------................................—------------ AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL.Ej DRYWELL❑
CATIONAND 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 I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-. ABANDON HOUSE SEWER
c
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY: BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)CCESSPOOLS
OF PERMITTEE-- -....---
76A642D 663 1/53