HomeMy Public PortalAbout10732 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 10732 Miloann St• CROSS ST.
LOCALITY El Monte DISTRICT NO. SERIAL NO. PERMIT NO. c
NEAREST A S
CROSS ST. E'1 Monte Ave•
RECEIVED BY Ready for Inspection DATE ISSUED
OWNER P, L, MONAtt
MAIL
ADDRESS 272t' San Gabriel Blvd. USEZONE OCCUPANCY MAP
- � I BK PG
CITY Sgn Gabri 91 TEL.NO. AT 94364
CONTRACTOR .+ DO & ma Construction 12G CO.IMP.N0.
ADDRESS 408—Ylint rop T)rs JOB.NO.
CITY b"hra TEL.NO. At 48315 TRUNK PERMIT NO.
ry STATE
REGISTRATION NO. j j rjr j,,; , 42 COUNTY ROAD PERMIT NO.
LEGAL
DESCRIPTION LOT N0. 25 STATE ENCROACHMENTPERMIT NO.
BLOCK TRACT 17867 INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO.OF BLDGS.
NOW ON LOT 1 CHARGES
USE OF
BUILDINGS 1 Reg, CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLICSEWER 0 $ 3.50 RECEIPT NO. i DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR I EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00 J N0. DATE BY
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
i�PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 ! MANHOLE REFERENCE
i UPPE.1 LOWER
TYPE OF CONNECTIONLENGTH FROM
Y. CURS P.L. M.L.TO P.L.
OWNERS PERMIT $ E 1 00
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMt
HAVE
TO CONNECT THE ABOVE DESCRIBED EXISTIAPPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS....................DAY OF........................................14.._ HOUSE SEWER
OWNER OR NECT ADDITIONAL
OWNERS AGENT......... ............................................
ILDING OR WORK
TIC TANK,SEEP.PIT(S)
ADDRESS_- ................_---•--• - - .................... D/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPSPOOL DRYWELL I]
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGR
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. AGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNNDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT t AM THE LEGAL OWER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. CKFILL SEPTIC TANKS
SIGNATURE P.PIT(S)[j CESSPOOLS(�
OF PERMITTEE----------------------- _.....-_............. �—
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