HomeMy Public PortalAbout9667 LONGDEN AVE_Sewer__ • DEPA-ICT"NT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDIN6 y
ADDRESS l 1. Longden AVIA
FOR APPLICANT TO FILL IN LOCALITY Temple City
BUILDINGA` NEAREST
ADDRESS _9675E. longden Ave, CROSS ST.
LOCALITY Temple Citi' DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A S
CROSS ST.
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER Don Richardson
MAIL
ADDRESS 110 Ise. Sierra Dr. USEZONE OCCUPANCY MAP
C BK PG
CITY Arcadia, Calif.lif. TEL.NO. Do ry 0583
CONTRACTOR A. L. Creme & "on
CO.IMP.NO.
ADDRESS 1500$ 1. Klondike Ave, JOB N0.
CITY Fare=Unt, Calif''(EL.NO. te36089 TRUNK PERMIT NO.
iTATE
REGISTRATION NO. C. 42.111228 ❑ COUNTY
ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT NO. West 132 Ft. of tot 8 STATE ENCROACHMENT
PERMIT NO.
BLOCK l TRACT &3 tr- Anita Lead Co. INDUSTRIAL
SIZE OF LOT NO.OF BLDG". L
WASTE APPROVAL
NOW ON LOT 6 CHARGES
USE OF
BUILDINGS Dwelling CONNECTION CHARGE FEE
-.NO. DESCRIPTION OF WORK FEE
-- --------- --- REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ $ 3.50 ) RECEIPT NO. ( DATE BY
HOUSE SEWER CONNECTING TO
PriVATE DISPOSAL SYSTEM 1.00 f
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED`
WORK TO HOUSE SEWER 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/ORDRAINFIELD
CESSPOOL—DRYWELL 2.60 STATION DEPTH
_SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
UPPER LOWER
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT $ i 00 Y. CURB P.L. M.L.TO 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
OWNERS AGENT.............................................................................. BUILDING OR WORK
__-__-.__ SEPTIC TANK,SEEP.PIT(S)
ADDRESS-.__---.____
------------------- ------- AND/OR DRAlNFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL 0 ORYWELL❑
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDENANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
IHEREBY CERTIFY THAT I 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 nESCRIBED RESIW:NiIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)E] CESSPOOLS
OF PERMITTEE..:" __--- - ----- --------
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