HomeMy Public PortalAbout5723 AGNES AVE_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508EWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE-0508- 1010180001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
(LEGAL ID: SEWER / SEPTIC: SEWER 1 BUILDING ADDRESS: 1
ITR: 6561 LT: 425 (EXIST OCC GRP: 1 5723 AGNES AV 1
I 1BLDGS. NOW ON LOT: 1 TEMP CA 917802604 1
ASSESSOR INFORMATION NUMBER: (CONNECTION TYPE: I NEAREST CROSS STREET: 1
18587-028-006 - (ORIGINATION: THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY, Cl
(LENGTH ML TO PL: STATION: DEPTH: 1 1
(TENANT: (MANHOLE REFERENCE: UPPER/LOWER: (ISSUED ON: PROCESSED BY:
I. I 110/18/10 SR
I (COUNTY IMPROVEMENT NUMBER:
10WNER: TEL. NO: 1PLAN CHECK NUMBER: (FINAL DATE FINAL BY: CODE: 1
(DAM, STEVEN (626) 625-5248- IJOB NUMBER:
15723 AGNES AV (TRUNK PERMIT NUMBER: I �& 1r(
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1TEMP 917802604 (ROAD PERMIT NUMBER: 1DESCRIPTION OF WORK
I 1AFFADAVIT: NO (CONNECT NEW RESIDENCE TO PUBLIC SEWER 1
I (WAIVER: NO
(APPLICANT: TEL. NO: (EASEMENT: NO '
ICHAN, SIMON (626) 318-9839- 1 1 I
I 1
15334 N. BURTON AVE (RECORD INSTRUMENT NBR: RECORD DATE: (SPECIAL CONDITIONS:
1SAN GABRIEL 91775 1HIGHWAY/STREET WIDENING: 1 ' I
(STATE ENCROACHMENT PERMIT NUMBER: 1
CONTRACTOR: TEL. NO: 1
(SEASON CONSTRUCTION, INC. (626) 625-5248- 1 FEES PAID ]APPROVALS DATE INSPECTOR SIGNATURE 1
19320 RALPH STREET LIC. NO IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: (NEW HOUSE SEWER 1 1
IROSEMEAD, CA 91770 827959 B 1
I 101 PERMIT ISSUANCE FEE 27.80 1CONNECT ADDITIONAL 1 I
I 103 CONN TO PUBLIC SEWER 1.00 CON 47.00 (BUILDING OR WORK I 1 1
1 -ARCHITECT OR ENGINEER: TEL. NO: 1 TOTAL FEES 74.80 1 1 I 1
I LIC. NO: ISEPTIC TANK, SEEPAGE PITT I I
1 1AND/OR DRAIN FIELD I I I
I 1 IDRYWELL _ 1
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1 SEWER MAP BOOK: PAGE: I 1ALTER, REPAIR, SEWER OR 1 I 1
1 (SEWAGE DISPOSAL SYSTEM
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1 1REPORT ID: DPR266 ROUTE TO BS0508
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