HomeMy Public PortalAbout10601 SPARKLETT ST_Sewer__ DEPA19TElIENT OF COUNTY ENGINEEB SEWER-SEWAGE DISPOSAL 1 `
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
OGUNTY OF LOS ANGELES
WILLIAM J. FOX. CDUHTY EmummN BUIL
AODRE86DING 0
FOR APPLICANT TO RLL IN LOCALITY
ADDRESS 10601 Sparklett St. CROSRasr U
LOCALITY Temple City DISTRICT NO SERIAL NO Q PERMIT NO.
M6AREST El MOIIte Ave. `� A / / 5
CROSS ST
EC V[D SY Root Nr IO.p..Um DAT[ISSUED
OWNER P.L. MDHlltt
MAIL 272� San Gabriel Blvd. U6EZONE OCCUPANCY MAP
MAILADDRESS
SK PS
CITY San Gabriel Tu No At 94364 A
CONTRACTOR L.D. & M. Const. Co. C4
ADDRESS 21 19isteria Ave. JOB NO SS
CITY AroadLa TEL NO Do 82238
TRUNK PERMIT NO
REGISTRATION NO 113613 - C 42 STATE
COUNTY ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO 96 STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
SIZE OF LOT NO OF BLDOS WASTE APPROVAL NOW ON LOT 1 CHARGE
USE OF
BUILDINGS Bea. CONNECTION CHARGE FEE
NO DESCRIFlTION OF WORK FEE
HOUSE SEWER CONNECTING TO3 REIMBURSEMENT FEE
PUBLICSEWER a 1 SMI RECEIPT NO DA BY
HOUSESEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CDNNE AD ITIONAL B OR EXCEPTION RECO ED
WORK TO HOUSE SEWER 100
ALTER OR REPAIR EXISTING NO DA�lf JOY
SEWER OR DISPOSAL SYSTEM 100
DISCONNECT AND ABANDON SEWER
ANO/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK SEEPAGE OB
PIT8 AND/OR GRAINFIELD 2.00 STATION 6
88 WELL -f 0 DEPTH
SPECIAL CONDITIONS ONLY 200 2 U/ �/ NHOLE
REFERENCE LOQ
TYPE OF CONNE 10NLENGTH FROM /
OWNERS PERMIT ; 11 OO w m° P L // M L.TO P L
AUTHORIZATION TOTAL FEE 1 4150
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING
DWELLING TO THE PUBLIC SEWER APPROVALS I018PlC70R'B SIGNATURE DAT[
SIGNED THIS DAY OF 19_ NEW HOUSE SEWER s7-6
rlinrk
CT ADDI
OWNERS AGENT _ _ _ _ _ __ _._ _ _ _ _ _ e fLWER OR OINGORWOHKAL '
ADDRESS _ - SEPTIOTANK SEEP PIT(S)
- - - - - -- - - -
AND/ORDRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLJ- CESSPOOL 0 DRYW[LL 0
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWEROR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
AMD/OR LICENSED IAB QUIRED THAT I BY LOS ANGELES PERLY GICOUNTY
DISCONNECT PLUG AND
AND
STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BACKNILL SEPYICTA II
SIGNATURE ''��
BEEP PIT(6)0 CESSPOOLbO
OF PERMITTEE L.D. /Il.M._.�pa,4ty_l�py_