HomeMy Public PortalAbout10618 SPARKLETT ST_Sewer__ DEPAICPINEENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
CI�UNTY-OF LOS ANGELES / c
WILLIAM J. FOX. COUNTY ENGINEER AOop E88
FOR APPLICANT TO RLL IN LOCALITYDUILOIG
ADDRESS 10618 3I)aI'k1etL St. CWSSYT al�
LOCALITY Temple City - DISTRICT NO SERIAL NO PERMIT NO
NEREST
CCRROSSBBY El Monte Ave. 5 A grr- Z$
i fIV BV ROAJb far InvooU0n DATEISSUED
OWNER P.L. MGKkttMIL
ADDRESS 272' San Gabriel Blvd. UBE ZONE OCCUPANCY SK MAP PG
cITYSan Gabriel TEL HoAt 94364 A_
CONTRACTOR L.D. & M. Const. Co. .y7
ADDRESS 21 Wisteria Ave, JOB NO
CITY Aroadia TEL Nolo 62238 TRUNK PERMIT NO
REGISTRATION NO 113613 - 042 COUNTY
ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO 92 STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
WASTE APPROVAL
SIZE Of LOT NO OF SLDGB
NOW ON LOOT
2 CHApG
USE OF
BUILDINGS RBS• & Gerage CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TOREIMBURSEMENT FEE
PUBLICSEWER ! S Sm S 50 RECEIPT NO DATE IBY
HOUSE SEWERCONNECTINGTO
PRIVATE DISPOSAL SYSTEM 100
CONNECT AD ITIONAL BLDO OR EXCEPTIO RECORDED
WORK TO HOUSE SEWER 100
L ER OR REPAIR EXISTING
S18NO TE BY
EWER OR DISPOSAL SYSTEM 100
DCOMNECT AND ABANDON SEWER
AMD/OR DISPOSAL SYSTEM 100 CONNECTION DATA
PIT$AND/OR GRA NFGIELDIT ON Zm
STATION +6q- O DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 200 /u / MANHOLEeKRfFERENCE A
!� �,L/7 LOWER
TYPE OF CONNECTION LENGTH FROM
OWNERS PERMIT s 1 00 Butte P L N L TO P L -
AUTHORIZATION I TOTAL FEE 4 50
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTORS SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS DAY OF__ 19— NEW HOUSE SEWER 7- SL
OWNER OR [ACTER
NNECT ADDITIONAL
OWNERS AGENT _ _- _ _ _ _ ---_ _ _ _ ILDING OR WORK
ADDRESS O/OR GRAINFIELD PIT(S)
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- SSPOOL C] ORYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REPAIR SEWER OR
REGULATING PL MBINfi AND
BEW ER8 WAGE DISPO>�iAL SYSTEM
AND/OREBY LICENSED�AS REQUIRED FY THAT I BY PROPERLY
ANGELES (COUNTY
CONNECT PLUG AMD
ANDSTATE OF CALIFORNIA OR THAT I AN THE LEGAL OWNANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY CkrILL SEPTICTANKS
n�T
LSIGNATURE SEEP PIT(B) CE88POOLSo
OF PERMITTER. s ,per & M r_�„ot Co- ml
TBAom BBS vas ej.)e"