HomeMy Public PortalAbout10650 SPARKLETT ST_Sewer__ DEPAIMBIE iT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DMSION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAtA J. FDX, COUNTY ENGINEER ADDRILDING
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APPLICANT TO-FILL IN LOCALITY
Sparklett St. EAREST zCROSS STle City DISTRICT NO SERIAL NO PERMIT NO
Monte Ave. AJ 9 S2 –Sl. McNutt RE IVSD Y Raadf f0rinp..tl.0 DAT[Is[U[D
FOR
Gabriel Alva, h--/G
ADORfiBB R USEZONE OCCUPAYCV BK YAP PO
c1rYSan Gabriel TEL No At 943o4 _/ �N�yI. V
CONTRACTOR L.D.& M Const. Co. CR.+MY.NG IJQ 3
ADDRESS 21 19isteria Ave.
ioe rD
CITY Arcadia TEL NO Do 6.:.238 STATE
TRUNK PERMIT NO
REGISTRATION NO 113613 - o42 COUNTY
ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO BZ STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
WASTE APPROVAL
BILE OF LOT NO
OF BLDOB
NOW ON LOT 2 CHAR 8
BUIOF
LDINGS Res. & Garage CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO - 3 50 REIMBURSEMENT FEE
PUBLIOSEWER ® 3 330 RECEIPT NO I ATE BY
HOUSESEWEROON E TINGTO
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLOB OR EXCEPTIO)i RECORDED
WORK TO HOUSE SEWER -100
ALTER OR REPAIR EXISTING / NU DATE BY
SEWER OR DISPOSAL SYSTEM 100
DISOONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK SEEPAGE PIT OR
PITS AND/OR GRAINFIELD 400 STATION DEPTH
E Po WELL
SPECIAL CONDITIONS ONLY 400 �/ MANHOLE REFERENCE
'YilSRVV LOWER
TYPE OF CONNECTION LENGTH FROM /
OWNERS PERMIT : 1 00
CV" L I�LL L TO P L
AUTHORIZATION TOTAL FEE 4 50
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTINGAPPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS--DAY OF 19.' NEW HOUSE SEWER
OWNER OR I CONNECT ADDITIONAL
OWNERS AGENT_ _ _ _ _—___ ___ _ _ _ _ _I BUILDING OR WORK
ADDRESS _ _ _ _ - AMD%OR GRAINF BEEPELD 1T(8)
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI-' CESSPOOL❑ DRYWELL
CATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWEROR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
TERED
AND%OR LICEEREBY NSED IFY THAT I AS REQUIRED BY PLOP EANGELES(COUNTY
DISCONNECT PLUG AND
AND STATE OF CALIFORNIA ON THAT I AN THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY SACXFILL SEPTICTANKSnn
SIGNATURE L. BEEP PIT(S)[] CESSPOOL$[]
OF PERMITTEE__D _& 17Ia anm k- ,( _� �q L
TOAN4D S/3 1/Oi V.l� 1