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HomeMy Public PortalAbout5312 ARDEN DR_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL DIVISION OF BUILDING AND SAFETY ` PERMIT APPLICATION COUNTY OF LOS ANGELES 7 BUILDING" WILLIAM J. FOX. COUNTY ENGINEER I ADDRESS FMOnte, OR APPLICANT TO FILL IN LOCALITY .. � • NG NEAREST f SS -5312 North Arden Drive CROSS ST. 1.2PJ� TY Temple Cit Ca1if• DISTRICT NO. SERIAL NO. ' PERMIT NO. c ST A. �T G a J ST. �J� RECEIVED BY, Ready for Inspection DATE ISSUED Owen tl MCEnroe p /�/4 SQL USE ZOy E OCCUPANCY SSPG TEL.NO. �q�/ ` �vV CTOR BURKE-?TOWARD CO.IMP. NO. SS 2L_36 No. Rosemead Blvd. JOB NO. MOnMOnte, Calif.TEL.NO. TRUNK PERMIT NO. ❑ STATE REGISTRATION NO. ❑ COUNTY. ROAD PERMIT NO. LEGAL STATE ENCROACHMENT DESCRIPTION LOT N0. PERMIT NO. BLOCK 13 TRACT / WASTE APPROVAL \ / SIZE OF LOT � R'�, V NO.OF BLDGS' / CHA GES V NDIMONLOT f USE OF BUILDINGS Dwelling CONNECTION CHARGE FEE N0. DESCRIPTION OF WORK FEE / \ REIMBURSEMENT FEE HOUSE SEWER CONNECTING TO 1 PUBLICSEWER Q S 3.50 3 50 RECEIPT NO. I/ DATE\ I BY HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 CONNECT ADDITIONAL BLDG.OR CEPTION RECORDED WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING y0- I DATE \ I BY SEWER OR DISPOSAL SYSTEM 1.00 DISCONNECT AND ABANDON'SEWER AND/OR DISPOSAL SYSTEM 1.00 CONNECTION DATA SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR.DRAINFIELD 2.00 STATION DEPTH CESSPOOL—D RY W E L L SPECIAL CONDITIONS ONLY 2.00 ['S ` MANHOLE REFERENCE LOWER TYPE OF CONNECTION LENGTH.FROM 0' OWNERS PERMIT $ 1 00 Y.�- —CURB— P.L. M.L.TO P.L. AUTHORIZATION TOTAL FEE, 1 4 50 IHAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECT OR'SSIGNATURE DATE DWELLING TO THE PUBLIC SEWER • Is'9 SIGNED THiS.....f_______ .D .__._I iC__Q�__ ____�_ NEW HOUSE SEWER CONNECT ADDITIONAL 1 OWNER 8� BUILDING OR WORK 0 •-------•----•--- -=-..................... - p SEPTIC TANK,SEEP.PIT(S) ADDRESS YSL�-i�: `!_W .(3fVSJ.`a.a_ AND/ORDRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL E] DRYWELL CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR. REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM I HEREBY CERTIFY THAT I AM PROP LY REGISTERED AND/OR LICENSED AS REQUI NGELES COUNTY DISCONNECT PLUG AND AND STATE OF C THE LEGAL OWN- ABANDON HOUSE SEWER ER OF THE NTI PROPERTY. BACKFILL SEPTIC TANKS dJ SEEP.PIT(S)ll CESSPOOL SIGNATURE , OF PERMITTEE........... - -- U. - - - 76A642A 663 7/5$ .......••• CE808Y8•58 A PUCATI®DF.I . FOR PER11�0��T,, COUNTY OF LOS ANGELES- StWER-SEWAPE DISPOSAL DEPARTMENT OF COUNTY ENGINEERuQ1 1116' BUILDING AND SAFETY DIVISION BUILDING JOHN'A. LAMBIE, County,Engineer ADDRESS CASSATT D. GRIFFIN, Sup't of Building LOCALITY C� ...-. ..,..-.: _ NEAREST / FOR APPLICANT TO FILL IN CROSS ST. LEGAL .OWNER _. . DESCRIPTION LOT NO. BLOCKTRACT Jz / l9 MAIL 6 ADDRESS a� NO.OF L GS. SIZE OF LOT. o`T, �J O NOW ON LOT I CITY TEL.NO. USE;OF. BUILDINGS �y/P /'» ESTATEENCROACHMENT 0. GROUP MAP PROCESSED-BY n K PG s CONTRACTOR71 ✓ p[ ADDRESS �r CONNECTION DATA ro CITY TEL. NO: / DEPTH. STAT .REFERENCE UPPER REGISTRATION NO. O—COULOWER NO.- DESCRIPTION.OF WORK FEE -HOUSE-SEWER'CONNECTING TO PUBLIC SEWER @ $3.00 E OF CONNECTION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR CURB P.L. M.L.TO P.L. 7T PITS AND/OR DRAINFIELD @ $3.00: OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,CESSPOOL,DRYWELL,MANHOLE @ $2.00 -HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL.SYSTEM @ $1.00. N0. JOB CONNECT ADDITIONAL BLDG.ORERMIT NO. AD PERMIT N0: WO K TO HOUSE SEWER @ $1.00LTE Effi+R-9R-A•Be '^SOUS& GJCROACHMENT @ $1.00 PERMIT NO. INDUSTRIAL ". WASTE'APPROV - - CHARGES OWNERS+ PERMIT $ 2 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT•THIS DATE A CONTRACT WITH THE HEREIN NAMED CON. APPROVALS DATE,- INSPECTOR'S.SIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED.EXISTING'DWELLING c TO THE PUBLIC.SEWER., SIGNED THIS------DAY OF 19_ NEW HOUSE SEWER ' OWNER OR CONNECT ADDITIONAL» _ OWNERS AGENT BUILDING OR WORK _ SEPTICaTANK:SEEP,'PIT(S)- ADDRESS AND/OR DRAINFIELD - - - 'I E HEREBY ACKNOWLEDGE-THAT-, HAVE READ THIS APPLICATION AND STATE THAT'THE'ABOVE IS'CORRECT AND AGREE TO COMPLY CESSPOOL❑.,DRYWELL❑' WITH ALL COUNTY ORDINANCES AND STATE LAWS 'REGULATING ,, ,AAfTERIREPAIR SEWER Oft p tc t r PLUMBING 'AND SEWERS. y ----'�' - @ (SEW'A'GE DISPOSAL SYSTEM -moo I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED BY LOS ANGELES. COUNTY AND STATE OF `j ABANDON HOUSE,SEWER• CALIFORNIA OR THAT I AM THE LEGAL OWNER,OF THE ABOVE DESCRIBED RESIDENTIAL PROF E TY. ' BACKFILL SEPTIC TANKS❑ --. .. SEEP. PIT(S) ❑ CESSPOOLS ❑ SIGNATURE OF PERMITTEE �p VALIDATIO ROBERT A.WOOD 4s.. N.p,, CASE[ SUPERVISING MECHANICAL ENGINEER -0,01'`lp COUNTY OF LOS"ANGELES TEMPLE CITY. #- 0508 SEWER PERMIT . DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1005170001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE%CITY"CA 91780 - - PHONE: (626) 285-0488 . -EXT: ILEGAL"ID; 'ISEWER / SEPTIC: SEWER ( BUILDING ADDRESS: - - ITR: 11699 - UN:. .002 IEXIST OCC GRPr - 5332 ARDEN DR - - I.BLDGS. NOW ON LOT: _ TEMP CA 917803319 (ASSESSOR INFORMATION NUMBER: - LCONNECTION.TYPE: NEAREST CROSS STREET: FREER 18585-020-005 I.ORIGINATION: THOMAS PAGE.: 597 GRID: B4 LOCALITY: TEMPLE CITY,,CI - - - ILENGTH ML TO PL: .STATION:.• DEPTH: ' - TENANT: - - - - (MANHOLE REFERENCE:. - UPPER/LOWER: LISSUED-ON: PROCESSED BY: 1.05/17/10 SR ICOUNTY IMPROVEMENT'NUMBER: - - - IOWNER: , TEL. NO: 11PLAN.CHECK NUMBER:. - ...1FINALTE FINAL.BY: CODE.: MCENROE,-ROBERT - - JOB, NUMBER: .,q 5312 ARDEN.DR _ 1ITRUNK PERMIT NUMBER: ITEMP917803319.- - II,ROAD PERMIT NUMBER: . IDESCRIPTION OF WORK - IIAFFADAVIT:;,'NO ISPOT REPAIR OF CONNECTION UNDER DRIVEWAY OF SEWER MAIN LINE • - - ,I WAIVER: NO (APPLICANT: TEL. NO: 'I EASEMENT:" NO �• ROTO ROOTER - (661) 257-9200- iI - I.24971 AVENUE"STANFOR �I..RECORD, INSTRUMENT. NBR: RECORD DATE: (SPECIAL CONDITIONS: IVALENCIA, CA ";('HIGHWAY/STREET WIDENING: _ A. ' 'ISTATE ENCROACHMENT PERMIT NUMBER: CONT : FEES 401301RE..00IVE OAK AVE (661)NO2IC.9N00 FEE DESCRIPTION: QUANTITY-.:PUOM: AMOUNT: INEWkHOUSE..SEWER DATE � • INSPECTOR SIGNATURE IR 1 IARCADIA CA, 91006 - 186821C36 - 1,101 PERMIT ISSUANCE FEE 27.75 -CONVECT ADDITIONAL I, .115 ALT/REP HOUSE SEWER 1,.00 EAC. 50.45 (BUILDING OR WORK 1;ARCHITECT OR ENGINEER: TEL. NO: II - TOTAL FEES. X58.2.0 - - SEPTIC TANK, .SEEPAGE PIT I. 1. - - LIC. N0:' - .. I RA AND/OR DINFIELD _ - .< "... = ._• 1 - - DRYWE LL I. SEWER.MAP BOOK: PAGE: .ai _ 1ALTER, REPAIR, SEWER OR - I - _ •. SEWAGE_ DISPOSAL.SYSTEM CONNECT PLUG AND ABANDON HOUSE SEWER ( - I (BAC KFZLL ,SEPTIC TANKS — ;, I SEEP.• PIT _ CESSPOOL " i GRAYWATER SYSTEM. 1 I I " . * ADDITIONAL DATA ON FILE - 1 • ',.IREPORT ID: DPR266 ROUTE TO BS0508 I I I I I I