HomeMy Public PortalAbout10312 DAINES DR_Sewer__ DEPARTMENT.OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL 10
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION g
1 ? COUNTY OF LOS ANGELES
WILLIAM J. FOX. COUNTY ENGINEER ADDRESS BUILDING /
� I L�
FOR APPEICANT TO FILL IN LOCALITY �4
BUILDING//5_,?/_j / (� J NEAREST
ADDRESSTh /J�I/LA �1 CROSS ST. G
LOCALITY DISTRICT NO.V SERIAL N0. pPERMIT/N 0. c
NEAREST r�+ A �O O�(O J
CROSS ST. [ / RECEIVED Ready for Inspection DATE ISSUED
OWNER ,'14 b66
/ ,` / —
MAIL
ADDRESS USE ZONE OCCUPANCY MAP
CITY �`� TEL.NO. q I BK PG
CONTRACTORCallfornia Se1.7er nongl-C., CO.IMP.NO. tyC.9
ADDRESS 1317 Colearove Aver JOB.NO.
CITY Alontebello TEL.N%jNion 1-504a TRUNK PERMIT NO. ~_1
STATE
REGISTRATION NO.104445 ICAUNTY ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT NO. ��`
BLOCK TRACT INDUSTRIAL WASTE APPROVAL
��
SIZE OFLOT h N0.0F,BLDGS.
NOW N LOT 1 CHARGES
USE DINGS
BUILDI ..4 CONNECTION CHARGE FEE
NO. DESCRIFfTION OF WORK FEE REIMBURSEMENT FEEe
HOUSE SEWER CONNECTING TO sst�d
� PUBLIC SEWER @ $ 3.50 J � RECEIPT NO. DATE BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OREAFEPTION RECORBED
WORK TO HOUSE SEWER ' - 1.00 N0.
ALTER OR REPAIR EXISTING DATE Y
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 /�t jL 3 O, Q DEPTH 9
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00ANHOLE REFERENCE,
-I I f zs 4 UPPER LGeR
TYPE OF CONN TIO LENGTH FROM !
-QUJLB C P�:L M.L.TO P.L.
OWNERS PERMIT ; I I 00
-AUTHORIZATION -.TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED.
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS,,-- ? INSPECTOR'3SIGNATURE DATE
DWELLING TO THE P BLIC SEW
SIGNED THIS AY -...= - - NEW HOUSE SEWER ,'',} � O h //'4-
--r.
19____-3 :�
- OWNER OR CONNECT ADDITIONAL'
OWNERS ADEN _--- 1p3UILDIN OR WORK '
SEPTIC TANKSEEP.
ADDRESS----- - ------- .f........ ....... ... AND/OR DRAINF ELD PIT(S)
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL•E] DRYWELL E]
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 1 AM PROPERLY REGISTERED
AND/OR-LICENSED AS REQUIRED BY LOS ANGELES COUNTY DISCONNECT PLUG AND
AND ABANDON HOUSE SEWER
STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN- •. -�"' •�':y���
E_R OF THE ABOVE DESCRIBED R g`IDENTIAL PROPERTY. BACKFILLSEPTICTANKS
y SEEP.PIT(8) CESSPOOLS❑ ,
SIGNATURE / , r /I
OF PERMITTEE I/l ��_JJJ ` "• ""' r
76A042D 663 1/53
! t..�
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT'
DEPARTMENT OF PUBLIC WORKS 1 9701 LAS TUNAS SE 0508 0110230001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: SEWER / SEPTIC: X BUILDIN_G SS:
ON FILE EXIST OCC GRP: ~ 10312 DAINES DR
BLDGS. NOW ON LOT: TEMP CA 917802708
AMSTOIFTN FORMAT ION R: CONNECTION TYPE: NEAREST CROSS STREET: ARDEN
8586-028-007 ORIGINATION: THOMAS PAGE: 597 GRID: B_3 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
MANHOLE REFERENCE: UPPER/LOWER: PROCESSED B :
10/23/01 JK 04/21/02
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINA
M-1 ENTERPRISES (626) 574-8083- JOB NUMBER:
228 PAMELA RD. TRUNK PERMIT NUMBER:
ARCADIA, CA ROAD PERMIT NUMBER: DESCRIPT
AFFADAVIT: NO SEWER FOR NEW SFR
WAIVER: NO
APPLICANT: EASEMENT: NO
SUNNY CONSTRUCTION -
RECORD INSTRUMENT_NBR: ' RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET-WIDENING:-1
STATE ENCR0ACHMENT-ZPER•M,II T-NUMBER
CONTRACTOR: TEL. NO: —FEES`PA -D APPROVALS TE INSPECTOR SIGNATURE
SUNNY CONSTRUCTION AND DEVELOPMENT (626) 574-8083-
514 S 1ST AVE. LIC. NO FEE DESCR,IP_TION:�aj QUANTITY: UOM: AMOUNT: NEW HOUSE SEWER
ARCADIA, CA 91006 681634 B P7 7� Y
A01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL,
03 CONN TOVPUBLIOSEWER 1.00 CON 46.95 BUILDING OR WORK
ARCHITECT OTAL FEES 74.70
HAN, FREEMAN (626) 796-5899- SEPTIC TANK, G PI
9051 VALLEY BLVD. #104 LIC. N0: 1111111 AND/OR DRAIN FIELD
ROSEMEAD, CA 91770 C21976
SEWER MAP BOOK: PAGE: y [� [� Q {� � n �j �1 K
(� ALTER, REPAIR, SEWER OR
UVI)UV11(I�Jv�/J�1[UIGI SEWAGE DISPOSAL SYSTEM
_ DISCONNECT
PLUG AND
ABANDON HOUSE SEWER
p ff sTEs _
0 Q SEEP. PIT _ CESSPOOL _
Qy ® ®gGRAYWATER SYSTEM
se Vic Th��
REPORT ID: DPR266 ROUTE TO BS0508