HomeMy Public PortalAbout10727 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
BUILDING NEAREST
ADDRESS 10727 tri iloann St• CROSS ST.
LOCALITY E1 blo a DISTRICT NO. SERIAL NO. PERMIT NO. c
NEAREST A S
CROSS ST. li;1 yiontS Ayg y
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER
P. L• MC gutt
MAIL
ADDRESS 27Zi San Gabriel Blvd, USEZONE OCCUPANCY MAP
BK PG
CITY San G,brielTEL.NO. AT 94364
CONTRACTORL.I), & M. Construntion an. C0.lMP.NO,
ADDRESS 408 Winhtrop Dr. )OB.NO.
CITY Alba Ibra TEL-NO. AT 48315 TRUNK PERMIT NO.
STATE
REGISTRATION NO. 11,151SI 3 a COUNTY
ROAD PERMIT N0,
LEGAL
DESCRIPTION LOT NO. `L'3 STATE ENCROACHMENT
PERMIT NO.
BLOCK TRACT 17667 INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF SLOGS.
NOW ON LOT CHARGES
USE OF
BUILDINGS 1 tReS. CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
1 PUBLICSEWER_ NG TO @ t 3.50 I RECEIPT NO. I DATE BY
NOUSE SEWER CONNECTI
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG,OR I EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING - NO 1 DATE I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 I _ CONNECTION DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 _ STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE REFERENCE
- UrP'ER LOWER
TYPE OF CONNECTION LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERS PERMIT ; I r Oo_
AUTHORIZATION TOTAL FEE
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 OF.............................._......19...---.. NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT.-,............. BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS-------- --- ............-------_..... ................................................. AND/ORDRAINFiELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI• CESSPOOL I] 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 I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN. ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS I]
SIGNATURE SEEP.PIT(S)D CESSPOOLS
OF PERMITTEE-_-------------------...-..-...:..-..--:. —..: -.....
76A643D 663 1/53