HomeMy Public PortalAbout9707 CRAIGLEE ST_Sewer__ D
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11.55. APPLIOATMN FOR PERMT
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g& -88IL 11 DIVISION OF.BUILDING AND SAFETY S EWE R—SEWAGE D 8 S POSH L
Depoxtment of County Engineer
County of Los Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ' .ADDRESS - nNO.-
NO
CASSATT D. GRIFFIN, SUPT OFBUILDING - 1*; LOCALITY
"FOR APPLICANT TO FILL IN CROSS ST.
DESCRIPTION LOT N0.LEGAL � OWNERMAIL ".wBLOCK TRACT s" ADDRESS
NO. OF BLDGS.SIZE OF LOT W ON LOT CITY TEL.
USE OF DISTRICT NO. GROUP MAP
BUILDINGS BK PG
CONTRACTOR '
CONNECTION DATA
ADDRESS R-
7-" 1 ''STATION DEPTH
CITY TEL. NO. / - .
1.. MANHOLE REFERENCE _ - UPPER
❑ STATE LOWER
REGISTRATION N0. ❑ COUNTY `
c No. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNECTION LENGTH FROM
PUBLIC SEWER @ $3,50
-
Y. CURB -P.L. M.L. TO F.L.
�
SEPTIC TANK,SEEPAGE PI,T OR - -
PITS AND/OR DRAINFIELD, - (tai $3.00
OVERFLOW SEEPAGE PIT, D P. C. N0,
E @ $2.00 A CO. IMP. NO. JOB NO.
HOUSE SEWER CONNECTING TO -
PRIVATE DISPOSAL SYSTEMchi $1.00 TRUNK PERMIT NO. ROAD PERMIT NO.
CONNECT'ADDITIONAL BLDG.OR, STATE ENCROACHMENT '
WORK TO HOUSE SEWER @ $1,00 PERMIT NO.
ALTER;REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM a $1,00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT PERMIT S 1 00
AUTHORIZATION TOTAL FEE
REIMBURSEMENT,FEE
d
1 HAVE.AT THIS DATE A CONTRACT WITH THE HEREINNAMED CON- APPROVALS _ DATE INSPECTOR''SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED.EXISTING DWELLING
TO THE PUBLIC SEWER. _ NEW HOUSE SEWER
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL
OWNER OR - .BUILDING OR WORK
OWNERS AGENT SEPTIC TANK,SEEP;PIT(S)
ADDRESS AND/OR DRAINFIELD
1 HEREBY,ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CESSPOOL❑ DRYW ELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS, SEWAGE DISPOSAL SYSTEM _
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT ABANDON HO PLUG PLUGUSE D '
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE-ABOVE
DESCRIBED RESIDENTI PROPE TY, 4 BACKFILL SEPTIC TANKS❑
SIGNATURE SEEP.PITS) LICESSPOOLS
OF PERMITTEE -
JOHN zA. LAMBIE. COUNTY ENGINEER VALIDATION ROBERTA. WOOD, CHIEF PLBG.'INSPECTOR
co
s CK b. 0. CAS
7 9 0
`` APR 1. 4 A 3.O 0 a
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0403300021
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: SEWER / SEPTIC: SEWER BUILDING ADDRESS:
ON FILE EXIST OCC GRP: R3 9707 CRAIGLEE ST
BLDGS. NOW ON LOT: TEMP CA 917801413
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: BARELA
5383-018-010 ORIGINATION: THOMAS PAGE: 597 GRID: Al LOCALITY: TEMPLE CITY, C
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED BY: EXPIRES ON:
03/30/04 VG 09726/04
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: TC PC 02-6 FINAL DATE FINA BY.: -GODE:
ROSENGREN, KENNETH (626) 285-2775- JOB NUMBER: _2-
9707 CRAIGLEE ST TRUNK PERMIT NUMBER:
TEMP 917801413 ROAD PERMIT NUMBER: DESCRIPTION OF WORK
AFFADAVIT: NO CONNECT EXISTING RESIDENCE TO PUBLIC SEWER
WAIVER: NO
APPLICANT: TEL. NO: EASEMENT: NO
GRBAVAC (626) 355-1350-
RECORD 'INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIDENING:
STATE ENCROACHMENT PERMIT NUMBER:
CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
GRBAVAC, MLADEN (626) 355-13507
P. 0. BOX 660219 LIC. NO ' FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW HOUSE SEWER �Z
ARCADIA, CA 91006 364584 C42;*
01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL
03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. NO: 29 DISCON/ABANDH SEPTIC 1.00 SYS 30.45
TOTAL FEES 105.15 SEPTIC TANK, SEEPAGE PIT
LIC. NO: AND/OR DRAIN FIELD
DRYWELL
SEWER MAP BOOK: PAGE: ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
ABANDON HOUSE SEWER
BACKFILL SEPTIC TANKS _
SEEP. PIT CESSPOOL
GRAYWATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR266 ROUTE TO SS0508