HomeMy Public PortalAbout5339 PARMERTON AVE_Sewer__ (
Y �nIVISION OF BUILDING AND SAFETY FOR REIS PERMIT
GE DISPOSAL 1
Deportment of County Englnaa -
County of Los Angeles BUILDING 5339 Parmerton
JOHN A LAMBIE COUNTY ENGINEER ADDRESS 5
tD CASSATTD GRIFFIN SUPTOIBUILDING LOCALITY Temple City
FOR APPLICANT TO FEIN ca"s"e sT Daines
LEGAL
DESCRIPTION LOT NO Gj10 OWNER John Bartfuff
BLOCK TRACT / 3 6 ! MAIL
ADDRESS 5339 Parmerton
NO OF
SIZE OF LOT NOW ON LOTS G1TYTemple City TEL x061. 45825
USE OF -
BUILDINGS DISTRICT NO GROUP BK YAP PG
CONTRACTOR San Gabriel Plumbing
ADDRESSI 31 S* San Gabriel Blvd. CONNECTION DATA
,,,San Gabriel TEL XDAt, 0-8483 STATION DEPTH
MANHOLE REFERENCE UPPER
STATE Y LOWER
REGISTRATION NO 11+4715 COUNTY
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM
PUBLIC SEWER (] S 3 50 Y CURB P L Y L TOP L
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR DRAINFIELD ® 5 3 00
OVERFLOW SEEPAGE PIT GRAINFIELD P C NO
EXTN CESSPOOL DRYWELL MANHOLE ® $2 00 CO IMP NO JOB NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM Q 5 1 00 TRUNK PERMIT NO ROAD PERMIT NO
CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT
1 WORK TO HOUSE SEWER ® $100 1 00 PERMIT NO
ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM ® S 1 00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE '
OWNERS PalbuT s 1 00
AUORIZATION TOTAL FEE REI MBURSEN ENT FEE
TH
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS DATE INSPECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL L�
OWNER OR BUILDING OR WORK
OWNERS AGENT SEPTIC TANK SEEP,PIT(S)
ADDRESS AND/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER REPAIR SEWEROR
PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR DISCONNECT PLUG AND
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT 1 AM-THE LEGAL OW ER OF THE ABOVE
DESCRIBED RESIDENTIAL PROP . BACKFILL SEPTIC TANKS(3T
SIGNATURE tnn'� / � � SEEP PIT(S) C1 CESSPOOLS❑
OF PERMITTEE fi'f- �/�
JOHN A LAMBIE COUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CF Y 0 qFN -
L�(,D' 3 9-2. 4 N AW 18 10 A 2.0 0 :R