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�/ `
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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