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Home My Public Portal About6236 BURTON AVE_Sewer__ CESOB 76AB42D 3-62 APPLICATION FOR PERMIT ' COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL 11L'll DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING L TORN A. LAMBIE. County Engineer ADDRESS 69 .6 Burton St. WILLIAM A. IENSEN. Supt of Building jlL.CALTV Ban Gabriel NEAREST FOR APPLICANT TO FILL IN CFO55 ST d EGAL DESCRIPTION LOT NO. 5 OWNER MAIL BLOCK TRAC5993 ADDRESS NO. OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF OINGS L/�rQ�\/ , DISTRICT NO. GROUP MAP PROCESSED BY USE (( BK P/G] CONTRACTOR H williams __T ADDRESS 2315 E, 118 St. CONNECTION L.A. Calif. 5664608 5T IDN DEPTH CITT TEL. NO. UPPER El STATE ` REGISTRATION N0. 139.0.99 ❑ COUNTY MANHOLE REFER 21 S/" NO. DESCRIPTION OF WORK FEE TYPE OF CONTE LENGG``T''H FROM c) A HOUSE SEWER CONNECTING TO Y. �/ P.L. M.L.TO P.L. PUBLIC SEWER a $5.00 A P.C.NO. SEPTIC TANK.SEEPAGEPIT OR Gp,IMP. NO. lOB NO. V PITS ANO/OR DRAINFIELD @ $10.00 HOUSE SEWER CONNECTING TO. �. PRIVATE DISPOSAL SYSTEM @ $3.00 TRUNK PERMIT NO. ROAD PERMIT NO. CONNECT ADDITIONAL BLDG.OR AFFIDAVIT MY [AlA. RECORD. INSTR.NO. DATE WORK TO HOUSE SEWER a $3.00 OVERFLOW SEEPAGE PIT.DRAINF I ELD d EXTN,.CESSPOOL,ORYWELL.MANHOLE N 55.00 HWY.OR ST.WIDENING ALTER.REPAIR OR ABANDON HOUSE _ SEWER OR DISPOSAL SYSTEM 53.00 STATE ENCROACHMENT PERMIT NO, INpUSTRIAL WgSTEAPPgOVAL OWNERS PERMIT s i 2 00 I CONNECTION CHARGE FEE CHARGES AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON/- REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ / OWNER OR _ _ .1 NEW HOUSE SEWER OWNERS AGENT_ fCONNECT ADDITIONAL v ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR GRAINFIELD ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. CESSPOOL ❑ DRYWELL ❑ 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR.SEWER OR LICENSED AS REOUIRED BY LOSLANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT i AM THE EGAL OWNER OF, AND INTEND TO DISCONNECT PLUG AND gE510E IN, THE ABOVE EBCRIBEO RIAL PROPERTY. ABANDON HOUSE SEWER TEE SIGNATURE L,/f/ BACKFILL SEPTIC TANKS LlOF PERMITESIDENT ❑ BEEP.PIT(S) ❑ CESSPOOLS VALIDATION ROBERT A. WOOD CK, CASH SUPERVISING MECHANICAL ENGINEER M.O. LAUD 5 3 2 2^ MAY 2 8 1 0 A C]fiAfi2D EBG42D APPLICATION FOR PERMIT IIJ1 COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDIrvG JOHN A. LAMBIE, County Engine) ADOREss 36 Brx�4ri St. WILLIAM A. JENSEN, Sup't o1 Building LOCALITY San Gabriel NEAREST FOR APPLICANT TO FILL IN CROSS ST. T. nardan EGAL DESCRIPTION LOT NO. S OWNER 5903 MAIL BLOCK TRACT ADDRESS NO. OF L..S. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF n' BU ILnINGS -1 DISTRICT NO. GROUP MAP PROCESSED 8Y CONTRACTOR H CL � _ B� PG ADDRESS 2315 E. 118 St. 0914K CONNEC'. DATA CITYL.A. 59 Cali . HO 5664608 5 "°" DEPTH ElSTATE MAN HOLE REFS N O "" - UPPER• REGISTRATION NO. C3 COUNTY - NO. DESCRIPTION OF WORK FEE TYPE OFC N LENGTH FROM } HOUSE SEWER CONNECTING TO Y. y^ P.L. M.L.TO P.L. O PUOLIC SEWER (m 55.00 P,C.NO. SEPTIC TANK,BEEPAGE,PIT OR CO.IMP. NO. JOB NO. V PITS AND/OR DRAINFIELD SIO.00 HOUSE SEWER CONNECTING TO TRUNK PERMIT NO, ROAD PERMIT NO. O PRIVATE DISPOSAL SYSTEM 53,00 0 CONNECT ADDITIONAL BLDG,OR AFFIDAVIT AIVER •SEx[ RECORD. INSTR.NO. GATE WORK TO HOUSE SEWER 5,00 OVERFLOW SEEPAGE PIT,DRAINFIELD y EXTN„CESSPOOL.DRYWELNHOLE 55.00 ALTER.REPAIR OR ABA NHOUSE HWY.OR ST.WIDENING SEW R DISPOS 0 53,00 STATE ENCROACHMENT r PERMIT,NO. INDUSTRIAL II WASTE INDUSTRIAL a/ OWNERCHARGES S PERMIT s r�e- �I CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE -51 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. APPROVALS DATE INStECTOW551GNATURE SIGNED THIS DAY OF 19_ ' ^ OWNER OR `��I n NEW HOUSE SEWER OWNERS AGENT /' CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK,SEEP.PIT(S) HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS, CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I AM THE LEGAL OWNER OF. AND INTEND TO DISCONNECT PLUG AND RE51DE IN, THE ABO E ESCRIOE RESIDENTIAL PROPERTY. ABANDON HOUSE SEWER SIGNATURE p - OF PERMITTEE 9 BACKFILLSEPTIC TANKS ❑ SEEP.PIT(S) ❑ CESSPOOLS ❑ VALIDATIONN ROBERT A. WOOD CK. M. SUPERVISING MECHANICAL ENGINEER O. CASH 2 8 1 1 3 2 � 5 z � rtAv 0- COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SE 0508 9611250002 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA PHONE: (818) 285-0488 EXT: LEGAL ID: SEWER / SEPTIC: SEWER REPA BUILDING ADDRESS: TR: 5903 LT: 5 BL: .001 EXIST OCC GRP: 6236 BURTON AV N BLDGS. NOW ON LOT: SGAB CA 917752633 ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: LONGDEN 5386-006-040 ORIGINATION: THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: ROC SED B R S 11/25/96 LC 11/25/97 COUNTY IMPROVEMENT NUMBER: OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY- CODE: FANG YAN;MEI-XAI - JOB NUMBER: 6236 BURTON AV TRUNK PERMIT NUMBER: LJ b 'SAM SGAB 917752633 ROAD PERMIT NUMBER: DESCRIPTION OF WOR AFFADAVIT: NO SEWER REPAIR (ADD CLEAN-OUT TO EXISTING ON-SITE HOUSE SEWER _ WAIVER: NO LINE) APPLICANT: TEL. 0: EASEMENT: NO DONG PLUMBING COMPANY (818) 288-7511- RECORD INSTRUMENT-NBR:- -p -- RECORDDATE: - SPECIAL CONDITIONS: HIGHWAY/STREET,WIDENING:r- 0 STATE ENCROOAACCHMv1fP,ERMIT-NUMBER:*"%� CONTRACTOR: TEL. NO: ��F.EES'PAID' APPROVALS DATE INSPECTOR SIGNATURE DONG PHU LUU (818) 288-7511- /j/ �---�UA �\ 117 W. NORWOOD PLACE, #C LIC. NO FEE LDESCRIPTION:/ ONT3TY: UOM:Y/Q AMOUNT: NEW IOUSE SEWER SAN GABRIEL, CA 91776 654342/C36 �.S'/j / (y 01 PERMIT ISSUANCE FEE o27.75 CONNECT ADDITIONAL 15-ACT,/RE HOUSE)SEWER 1.00 EAC 30.30! 30.30 BUILDING OR WORK ARCHITECT OR ENGINEER: EL. 0: TOTAL FE \ 58.05 r ES SEPTIC TANK, SEEPAGE PIT LIC. NO: _ n+ I �.� AND/OR DRAIN FIELD SEWER MAP BOOK: PGE: ir. Q it;�-+� I� )` l i-7 C ALTER, REPAIR, SEWER OR I SEWAGE DISPOSAL SYSTEM �- O _DrS_C_0N_ffnT PLUG AND I Z•�� ABANDON HOUSE SEWER >� BACKFILL SEPTIC S i p SEEP. PIT _ CESSPOOL �1 � G W RSYSTEM ��rvac REPORT ID: DPR266 ROUTE TO BS0508