HomeMy Public PortalAbout10641 SPARKLETT ST_Sewer__ DEPARRTDILNT OF OOUNTY ENOIIIEM SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
OOITNTY OF LOS ANGELES BUILDING
WILLIAM J. FOX. COUNTY ENGINEER ADDRESS j Q
FOR APPLICANT TO RLL IN LOCALITY
BUILDING NEAREST (�
ADDRESS 10a41 Rparlrlet•t St. CROSS ST v
LOCALITY TEIIDg1� C1ty. DISTRICT NO A SERIAL NO PERMIT NO
NEAREBT J S. %�
CROSSST El Minta AvA, /RECEIVED BY Raft fw lap"Ua DATEISSUED
OWNER P.L, McNutt y �� /4 -
MA ADDRESS 272* San Grabiel Blvd, UBE 20NE OCCUPANCY BK MAP PB
CITY San Gabriel TELMO At 94364 /q — / VLC
CONTRACTOR L.D. & M- COnRt. CO. go-www T/^ 2 1
174
ADDRESS 21 Wisteria Ave. )OB.NO G S
CITY Aroadia TEL HO Do62238 TRUNK PERMIT NO
REGISTRATION NO 113613 - C 42 ❑ COUNTY
ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO 102 STATE ENCROACHMENTPERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
WASTE APPROVAL
812E OF LOT NO OF BLOBS
NOW ON LOT 2 CHA EB
USE OF
BUILDINGS Rea. & Garaae CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
REIMBURSEMENT FEE
HOUSE SEWER CONNIN TO
PUBLIC BEW ER @ 8 060 31 fio RECEIPT MO DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTION R ORDEO
WORK TO HOUSE SEWER 100 Na
ALTER OR REPAIR EXISTING TE BY
SEWER OR DISPOSAL SYSTEM 100
T AND A D ORNDI WOEALB STE °MM SEWER 100 CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR GRAINFIELD 2.00 STATION �+ � '� O DEPTH 4
CESSPOOL-0RYWELL
SPECIAL CONDITIONS ONLY 2001 lei ANHO�LEBREFERENCE B
TYPE OF
Co
IOM LENGTH FROM
OWNERS PERMIT $ I I OO el)RB P L t/ M L TO P L L S
AUTHORIZATION I TOTAL FEE 1 41150
I HAVE CONTRACTOR TO CONNDATE ECT THTE ABOVE DEEO WITSCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS __ DAY OF _ — _19— NEW HOUSE SEWER I sc.JI roG
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT _ - - — - - - - - BUILDING OR WORK
SEPTIC TANKi BEEP.PIT(S)
ADDRESS _ _ _ _ _ _ _ _ _ _ AND/OR DRAINPIELD
CATION AND STATE THAT THE ABOVE 9 CORRRECTTAND AGREE CESSPOOL DRYWELL
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED TY DISCONNECT PLUG AND
AND/OR LICENSED
OFBCALIFOfRNIA OR THAT I AH THEE LEGALL OWN ABANDON HOUSE SEWER g
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY BEEP PI LS)SEPTIC TANKS
SIGNATURE
PERM TTEE IIAIL_B-X_ .00718t.-CO-
i6A6U0 Ga __1/50