HomeMy Public PortalAbout10607 SPARKLETT ST_Sewer__ DETAILTDIEDM OF COUNTY ENOINEM SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUnMING AND SAFETY PERMIT APPLICATION '
oOU4W Ot LDS ANGELES _
WILLIAM J. FCX. COUNTY ENGINEER ADOR[BUILDI8E {7NG /Q
F
PLICANT TO RLL IN LOCALITY
BUILDNG Sparklett St. C OSSST
City DISTRICT NO SERIAL NO PERMIT NO.
te Ave. r A 9S� — 5
RUAy fw I..F..tl,O DATE IBsu[McNuttMAIL
ADDRESS 272 San G abriel Blvd. USE ZONE OCCUPANCY SI(MAP PG
CITY San Gabriel TEL No At 94364
CONTRACTOR L, D. & M. Comt. Co. oar Q 2
ADDRESS 21-Wisteria Ave, - IDB No S
CITY Arcadia TEL NO Do 62238 TRUNK PERMIT NO
REGISTRATION No 113613 — 042 ® STATE
COUNTY ROAD PERMIT NO
LEGAL 97 STATE ENCROACHMENT
DESCRIPTION LOT NO PERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
SIZE OF LOT NO OF BLDBS WASTE APPROVAL
NOW ON LOT 1 CHA 8
USE OF Rea*BUILDIHOS
CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE REIMBURSEMENT FEE
HOU8E SEWER CONNECTING TO .3
PUBLICSEWER F 850 RECEIPT NO DATE BY
HOUSESWEB CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLOB OR EXCEPTI RECORDED
WORK TO HOUSE SEWER 100
ALTER OR REPAIR EXISTING NO ATE BY
SEWER OR DISPOSAL SYSTEM 100
DISCONNECT AND ABANDON SEWER
AMD/OR DISPOSAL SYSTEM 100 CONNECTION DATA
PITS AMD/OR DRAINFIELDT Ofl 2.00 _
STATION �+I' }'- �} DEPTH /
CESSPOOL—ORYW LL
SPECIAL CONDITIONS ONLY 200 / / M NHOLE REFERENCE
(OS �✓� UPPER
TYPE OF CONN ION < i LENGTH FROM S�
OWNERS PERMIT { 1 00 �' -SNUB PL ML TDP L
AUTHORIZATION TOTAL FEE 4 60
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 ___ _ __ __ _ ______ _ _ _ BUILDIM80RWORK
ADDRESS _ _ _ _ _ SEPTICTANK SEEP PIT(S)
AMD/OR GRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL 0 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 1 AN PROPERLY REGISTERED D1860NMECT PLUG AND
ANO/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY
AMD STATE OF CALIFORNIA ON THAT 1 AM THE LEGAL OWN. ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY ISAURPILL8 PTIC TANKS
SIGNATURE I"'�
BEEP PIT(S)o CESBPOOL$O
D
OF PERMITTEE. L• � t91 �L�QnBt• GQ,L _ _
TSAUM Baa 1/08