HomeMy Public PortalAbout10644 SPARKLETT ST_Sewer__ DEPABTSfENT OF OOUNTY ENGINEER• SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUMDING AND SAFETY PERMIT APPLICATION
CDSNTY OF IAS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING ADDRESS u
ADDRESS
FOR APPLICANT TO FILL IN LOCALITY CiJI�
ADDRE NG 10644 3parklett St. GROSS;ST
LOCALITY Temple City DISTRICT NO SERIAL NO PERMIT NO -C
NEAREST $1 Monte Ave* A b-s
CROSS ST
RECEIVED BY R.Ab T.T INry..tlaN DATE ISSUED
OWNER P.L. McNutt j�_ --/G -)3
MAIL 272* San Gabriel Blvd. USEZONE OCCUPANCY MAP
ADDRESS
C1TYSan Gabriel TEL No At 94364 eN n
CONTRACTOR L.D.&M. Const, Co. G' 17 35�
t0.Wi4N0
ADDRESS 21 Wisteria Ave. JOB NO
CITY Arcadia TEL NO. & 6.x22738 TRUNK PERMIT NOSTATE
_
REGISTRATION NO 113613 - C 42 ❑ COUNTY
ROAD PERMIT NO
LEGAL BS \
DESCRIPTION LOT NO STATE ENCROACHMENT
NO
BLOCK TRACT 19189 INDUSTRIAL
WASTE APPROVAL
SIZE OF LOT NO OF BLOBS
NOW ON LOT 2 CHARGES
USED' Hes. & Garage CONNECTION CHARGE FEF
e0 DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLICSEWER - O 3 SSO 3 50 RECEIPT NO ATE IBY
HUSEEEMiER NM YO O
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL OLDS OR EXCEPTION RRDED
WORK TO HOUSE SEWER 100
ER�R[PA�RFXIBT M MO
SEWER OR DISPOSAL SYSTEM 100 DA BY
DIBCOMMECT AMD ABANDON SEWER
AMD OR DISPOSAL SYSTEM 1 Do CONNECTION DATA
P TANK SEEPAGE PIT OR
PITS ANO/OR GRAINFIELD 200 STATION 2t- 30� O DEPTH
CESSPOOL-DRYW LL
SPECIAL CONDITIONS ONLY 200 /S MANHOLE REFERENCE E -/LOWER
TYPE OF CONNECTION LENGTH FROM /
OWNERS
PERMIT = 1 00 4— BVRB PL V M L TO P L /
AUTHORIZATION TOTAL FEE 4 50
1 HAV[ THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE OAT[
DWELLING TO THE PUBLIC SEWER
SIGNED THIS DAY OF 19_ NEW MOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT _ _ — _ _ _ _ ___ _ _ _ __ _ BUILDING OR WORK
ADDRESS _ __ SEPTIC TANK BEEP.PIT(S)
AMD/OR GRAINFIELD
CATIONANDSTATE THATT THE ABOVE S CODGE THAT I HAVE RRAD RECTTAND AGREE CESSPOOL DRYWEII
TO COMPLY WITH ALL COUNTY ORDINANCES AMD STATE LAWS ALTER REPAIR SEWER OR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- ABANDON HOUSE SEWER
EB OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTYACKF A 11''""�1 -
SEEP PIT(8)� CEBBPO0 s'
OF PERNIT EE_ _ATURED• & M. Conat. CD.
TSAWD ON 1/59