HomeMy Public PortalAbout5128 MCCLINTOCK AVE_Sewer__ DEPARTMLrT'1' OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
_DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION 490 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CEE.R BUILDING cy
COUNTY NDINE.; I ADDRESS ��'
FOR•APPLICANT TO FILL IN LOCALITY
BUILDI s 5128 McClintock NEAREST e
CROSS.ST.
LOCALITY El Monte DISTRICT N0. -SERIAL NO. PERMIT NO.
NEAREST A 3 7
CROSS ST. RECEIVED BY Ready for Inspection DATE ISSUED
OWNERRoy Heath �ai� /��®
ADDRESS LSE/ONE OCCUPANCY BK MAP
MAIL
Same PG
CITY TEL.NO. �fy�l000 I P.45S
CONTRACTORCalif ornla -Seaver ConS•t o CO a CO.IMP.NO.
ADDRESS 1317 Colegrove Ave. ,OB F
CITY Montebello TELANNion 1-5048 TRUNK PER NO.
STATE
REGISTRATION No104445 S'tRIIDUNTY ROAD PERMIT NO-
LEGAL. C�' STATE ENCROACHMEN
DESCRIPTION LOT N0. ,a� / PERMIT NO.
BLOCK TRACTS 25 id INDUSTRIAL
/ WASTE APPROVAL
SIZE OF LOT /�l NOW ON LOTS �. C G
USE OF
BUILDINGS Re 8• CONNECTION CHARGE F
NO. DESCRIPTION•OF WORK FEE
1 HOUSE SEWER CONNECTING TO REIMBURSEMENT PEE
PUBLICSEWER @ $ 5.50 3450 RECEIPT I DATE Y
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT-ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 a N0. I DATE I BY
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
TANK,SEPTIC
P TS AND/ORDRAINFIELDEEPAGE PIT OR 2.00
CESSPOOL—DRYWELL STATION T7_L DEPTH �®
SPECIAL CONDITIONS ONLY 2.00 )�y/� ® ANH�OLERREFERENCE LOWE
/TYPE OF CONNECTION ENGTH FROM z� !�
OWNERS PERMIT ; I 00 V. CURB P.L. fl M.L.TO P.L.
AUTHORIZATION._ TOTAL FEE 4 50
I 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 O CL--_ 19 NEW HOUSE SEWER emd4,
y
WNER •�f�y �_ CONNECT ADDITIONAL
OWNERS AGENT..!�r.�l�',l._..,.. BUILDING OR WORK
Ji U — --
ADDRESS_._.----- 4L . SEPTIC TANK,SEEP-PIT(8)
+yR,F-•�•G-�.- - AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPL. CESSPOOL[:] DRYWELL
CATION AND STATE THAT THE ABOVE 18 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 ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DES RIB D RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS /.
SIGNATURE SEEP.PIT(tin CESSPOOLS --g .Ay0C_4_ /,g-j ' an
OF PERMITTEE. • -� •• ---.._.._.._....._......-
' -%642A 668 7/52 '