HomeMy Public PortalAbout10660 SPARKLETT ST_Sewer__ DEPAILTh1ENT OF COUNTY ENOINEEIL 1 SEWER—SEWAGE DISPOSAL 1
DrVISION OF BUnMING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES /
WILLIAA: J FOX. COUNTY ENDINEER ADDRESBUILDINSG
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BUILDING
FOR APPLICANT TO FILL IN LOCALITY
ADDRESS 10660 rkl akt Rte 6RO666TT
LOCALITY Temple Cit-y DISTRIOT No SERIAL Mo PERMIT NO
NEAREST fil ffiOIIte AVa• S— A 1Q/ s241-V6
OSS
CRST
OWNER P.L. MCTTat t i-NE
ED Y Rlao Ter 1E DATE ISSUED_
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A AIL 27- San Gabriel Blvd• Uei OOCUPAMOY MAP
BK PS
CITY San Gabrial TEL No At 94364 - A- 1
CONTRACTOR L.D.:.:. COTlSt. Go t=mww F C .L
ADDRESS 21 Wisteria Ave. JOB NO
--5
CITY Arcadia TEL NO DO 6?238 TRUNK PERMIT NO
REGISTRATION NO 113613 - y 42 COUNTY
ROAD PERMIT NO
LEGAL
DESCRIPTION LOT NO 85 STATE ENCROACHMENT
PERMIT NO
BLOCK TRACT 19189 INDUSTRIAL
NO OF BLDGB2 WASTE APPROVAL
S12E OF LOT NOW ON LOT CHARGE
USE OF
BUILDINGS 31aS Ta Garage CONNECTION CHARGE FEE
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO C REIMBURSEMENT FEE
PUSLICSEWER a S 560 RECEIPT NO DAT BY
HOUSE SEWER COMNECTINO O
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXCEPTIO RECORDED
WORK TO HOUSE SEWER 100
ALTER OR REPAIR EXISTING NO TE BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AMD/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIOTANX, EEPAGE
SITS AND/OR GRAINFIELD R 2.00 STATION'++ l p DEPTH
ESSPO L-0RYWELL
PECIAL CONDITIONS ONLY 200 M NHOLE REFERENCE•O�S UPPER ti4YEfl
rlr' TYPE OF CONN IONift"mP L LEL GGTOHPS
FROM � /
_OWNERS PERMIT s I 00
AUTHORIZATION I TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTORSSIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS --DAY OF —19_ NEW HOUSE SEWER1.2.-17-
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT_ __ — _ _ _ __ __ _ _ __ _ BUILDING OR WORK
ADDRESS _ SEPTIC TANK.SEEP PITS)
AND OR DRAINFIELD
CATIONREBY AND STATE THAT THE ABOVE 8YE READ CORRECTTAN0 AGREE
CESSPOOL[] ORYWELL
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR SEWEROR
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
IHEREBY REGISTERED
AND/OR LICENSED IAS REQUIRED BY FY THAT I AN PROP
ANGELESCOUNTY
DISCONNECT PLUG AND
AND STATE OF CALIFORNIA OR THAT I AY THE LEGAL OWN- ABANDON HOUSE SEWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY IIACkrILL SEPTIC TANKSII""'l�
SIGNATURE SEEP PIT(S)0 CESBPOOL$
OF PERMITTEE -1-1- �y�. ()Q".t. 414
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