HomeMy Public PortalAbout9669 LONGDEN AVE_Sewer__ DEPAWMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL I
DIVISION OF BUILDING AND SAFETY `-y. PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER "UILDING
ADDRESS s g -E, Longden ave
FOR APPLICANT TO FILL IN LOCALITY Tdmple City
BUILDINGNEAREST
ADDRESS 9675–]C. Longden Ave. CROSS ST.
LOCALITY Temple City DISTRICT NO. SERIAL NO. PERMIT NO. c
NEAREST A J
CROSS ST.
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER Don RichardsonMAIL
_
ADDRESS 110 La Sierra I)r. USE ZONE OCCUPANCY MAP
BK PG
CITY WW" Arcadia€ . • Do 70583
CONTRACTOR A. L. Crume &. Son
CO.IMP.N0.
ADDRESS 15008 E. Klondike) Ave. JOB NO.
CITY ParaWUnty CalifrEL.NO. Me 16089 TRUNK PERMIT N0.
STATE
REGISTRATION NO. Ca 42,111228 ❑ COUNTY
ROAD PERMIT N0.
LEGAL
DESCRIPTION LOT N0.West 132 1t. of Iota 8 STATE ENCROACHMENT
PERMIT NO.
BLOCK 1 TRACT Santa Anita Land Co• INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLOGS.
NOW ON LOT 6 CHARGES
USEOF
BUILDINGS Dwellina CONNECTION CHARGE FEE
NO.' DESCRIPTION OF WORK FEE
HOI1Sf SEWER CONNECTING TO REIMBURSEMENT FEE
UBLICSEWER 3.50 RECEIPT NO. DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00 I
GONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- i 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 AHD/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
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 I 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---------....._......_........._..._14 NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT.......................................................................------ BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS..---................_............ ----•--•-•-------•----•--------.--_-- AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL[:] DRYWELL 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
1 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. BACKFILLSEPTIC TANKS
(�
SIGNATURE SEEP.PIT(S)C] CESSPOOLS 0
OF PERMITTEE.:. ._.._..:. ..--...- ---•--.�_ ..:-----• ---------•-•---
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