HomeMy Public PortalAbout10733 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 1 73 Ln.n St. CROSS ST.
LOCALITY El bloats DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A S
NEARS ST. 3Monte Ave.•
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER P6L, McNutt
MAIL
ADDRESS 27 &Yl G�brx61 131vd• USEZONE OCCUPANCY MAP
BK PG
CITY Sall Gabt1®j TEL.NO. AT 94364
CONTRACTORL D. & X. Construction Co* CO.IMP.NO.
ADDRESS 408 Withrilip Dr, JOB.NO.
CITY Alhambra TEL.NO. AT 48315 TRUNK PERMIT NO.
REGISTRATION NO. 113613 — 0-42 7 STATE
LUJ COUNTY ROAD PERMIT N0.
LEGAL
DESCRIPTION LOT NO. 12 STATE ENCROACHMENT
PERMIT N0.
BLOCK TRACT INDUSTRIAL
178fi7 WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
NOW ON LOT + CHARGES
USE
BUILDINGS 1 R89a CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
1_PUBLIC SEWER @ $ 3.50 RECEIPT NO. DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00 i
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 i
ALTER OR AI
REPR EXISTING NO. I DATE !BY
_ SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER ! CONNECTION DATA
AND/OR DISPOSAL SYSTEM 1.00
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 I STATION DEPTH
_I CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 I MANHOLE REFERENCE
UPF'ER LOWER
! TYPE OF CONNECTIONLENGTH FROM
Y.-
CURB P.
M.L.TO P.L.
OWNERS PERMIT $ I 1 00
AUTHORIZATION TOTAL FEE I -
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
HAVE
TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTORS SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS-------------------DAY OE..........................._._......19........ NEW HOUSE SEWER
OWNER DR CONNECT ADDITIONAL
BUILDING OR WORK
OWNERS AGENT......................-•------•--...._.._.........._...._......-•---•
SEPTIC TANK,SEEP.PIT(S)
ADDRESS. _........- _._........................_....- AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPL!• CESSPOOL 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/ST LICENSED REQUIRED BY I A ANGELES COUNTY ABANDON HOUSE SEWER _
AND STATE OF CALIFORNIAIFOR THAT ! AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)E] CESSPOOLS Q
OF PERMITTEE...._ ------ _
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