HomeMy Public PortalAbout10720 LORA ST_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
• DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS �I U720Larl� St., CROSS ST.
LOCALITY El Monte DISTRICT NO. SERIAL NO. PERMIT NO.NEAREST
c
CROSS ST. 4'1 Monte AVdi• A a
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER P, L. MCr•NUtit
MAIL
ADDRESS 1 USE ZONE OCCUPANCY MAP
8K PG
CITY San Gabriel TEL.NO. AT94564
CONTRACTOR L• La Mo Construction Go* CO.IMP.NO.
ADDRESS 408 Winthrop Ar,
JOB.Na
CITY Alhambra TELAO. AT 46316
TRUNK PERMIT NO.
STATE
REGISTRATION NO. 11361 G-42 COUNTY ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT NO. Ej STATE ENCROACHMENT
PERMIT NO. _
BLOCK TRACT 1786V INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
NOW ON LOT CHARGES
USE OF "
BUILDINGS 1 R& CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
3 PUBLIC SEWER 0 $ 3.50 RECEIPT N0. - DATE +BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIOMAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING N® DATE BY
SEWER OR_DISPOSALSYSTEM 1.00
DISCONNECT AND ABANDON SEWEFf
AND/OR DISPOSAL SYSTEM 1.00 i CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYW ELL
SPECIAL CONDITIONS ONLY 2.00 I MANHOLE REFERENCE
UPPER LOWER
I TYPE OF CONNECTION LENGTH FROM
Y-. CURB P.L. M.L.TO P.L.
OWNERS PERMIT j I 1 00
AUTHORIZATION I 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........._............................ NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT......,............--,.._.....................--..-__.•...............
BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS-----.................._._._..._._..-.-...._.........-----•---........................... AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL E] DRYWELL
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 AND
DISCONNECT PLUG A
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
D
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)D CESSPOOLS
OF PERMITTEE..•:------------------------------...........................
...- --.:,.-
76A642D 663 1/53