HomeMy Public PortalAbout10703 MILOANN 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 `
BUILDINGNEAREST
ADDRESS 10703 ,1,1 p Tits 8bw CROSS ST.
LOCALITY El Monte DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST A S
CROSS ST. .i1 ]Uonte Ave, `—
RECEIVED BY Ready for inspection DATE ISSUED
OWNER P. L. geNutt
MAIL 272- San Garelvd. USE ZONE
ADDRESS Gabriel BOCCUPANCY MAP I I BK PG
CITY San GabrielTEL.NO. AT 94364
CONTRACTOR L" 7o conatnla j on _V0i CO.IMP.N0.
ADDRESS 408 Yxinthrop Dr, JOB.N0.
CITY Alhambra TEL.NO. AT 48315
TRUNK PERMIT N0.
STATE
REGISTRATION NO. 11 5461 3wC—&2 COUNTY ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT NO. STATE ENCROACHMENT
1 PERMIT NO.
BLOCK TRACT 17867 INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
NOW ON LOT 1 CHARGES
USE
BUILDINGS DCONNECTION CHARGE FEE
1, �®8.
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
l PUBLIC SEWER $ 3.50 RECEIPT NO. I DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAlR EXISTING NO. I DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00 f
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM IAO CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
_ PITS AND/OR DRAINFIELD 2.00 ( STATION DEPTH
CESSPOOL—DRYW ELL I
SPECIAL CONDITIONS ONLY 2.00 f MANHOLE REFERENCE
M lUP,PER- LOWER
TYPE OF CONNECTION LENGTH FROM
Y. fl-iRB P.L. M.L.TO P.L.
OWNERS PERMIT $ 11 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
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL C] DRYWELL 0
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 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 DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS E]
SIGNATURE SEEP.PIT(S)[] CESSPOOLS❑
OF PERMITTEE-- =- -...................:...
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