HomeMy Public PortalAbout6260 TEMPLE CITY BLVD_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENDINpER BUILDING
AGGRESS
FOR APPLICANT TO FILL IN
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LOCALITY DISTRICT NO 8 RIAL NO PERMIT NO
_EST G/ 5- A
NEAREST /O s✓
CROSS BYYJ/ C_ / CEIVED BY Ready for Inrpoetloo DATE ISSUED
OWNER{Y/f. 'O/{�J'/ L� S` - S
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ADDRESS -$dL rl7 �, —yam PA BK PG
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CONTRACTOR G r ��LA Son CO IMP NO I Z� - 3 N,
AGGRESS C-2,5.;?.,[-3 L �_3 G/ Sf COB NO
CITYCO�� /� n TEL NO/7-0-� J'5P,?2/ TRUNK PERMIT NO
�Y 7�� G4 Z e COU MTY ROAD PERMIT NO
-REGISTRATION NO ^' J �7� 55
DESCRIPTION LOTIID ' ��'de m� W/�9-4C> pER111T N0�ACHMEN7
BLOCK N TRACT yf �, RIAL
WASTE A PROVAL �-
8126 OF L [ 00' NOW OM LOTS CHARGES
USE OF _ ///
BUILDINGS �lil OOpNECTI AflBE FEZ
MO DESCRIPTION OF WORT FEE
NOUBE SEWER CONNECTING TO REIMBURSEMENT FE
PUBLIC SEWER a $ 860 RECEIPT NO TE BY
USE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 100
CONNED ADDITIONAL BLDG 0 EXCEPTION RECORDE
WORK TO HOUSE SEWER 100 NO
ALTER OR REPAIR EXISTING M DATE B
SEWER OR DISPOSAL SYSTEM 100
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC AM PAGE PIT OR I
PITS AND/OR GRAINFIELD 200 rAND/Oft
Q DEPTH
CESSPOOL--0 ELL
SPECIAL CONDITIONS ONLY 200 I M LG EFERENCE
PPEF
E CTION LENGTH FROM
CUR METOPE
OWNERS PERMIT i 1 00
AUTHORIZATION TOTAL FEE
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE A VE DE BED EXISTIROVALS INSPECTOR'S SIGNATURE DATE
OW[LLCM TO T E PUBLIC SEW
�6NED THIS DAY OF_ I USESEWER $ 245
OWNER ON T ADDITIONAL
OWNERS AGENT_ _ OORWORK
ADDRESS__ _ TANK,BEEP.PITS)
,y�-� ��_-- - R DRAIKFIELD
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- OL 0 DRYWELL
CATION AND STATE THAT THE ABOVE I8 CORRECT AND AGREETO COMPLY WITH ALL COUNTY ORDINANCES AMD STATE LAWSREPAIR SEWEROR
REGULATING PLUMBINE AND SEWERS E DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED
AMD/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND
ABANDON HOUBEBAND
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
EWER
ER OF THE ABOVE DESCRIBED RESIDENTIAL PRO-- BACKF SEP IC VAN kaSIG
NATURE �') ^
OF /y
SEEP PIT(S)Q CESSPOOLS SG`I e2-6
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