The URL can be used to link to this page

Home My Public Portal About10516 DAINES DR_Sewer__ S&E-6ae11-55 APPLICATION FORR PERMIT 1 E DIVISION OF BUILDING, AND SAFETY SEINER-SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILIING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS ® CASSATT O GRIFFIN SUP T OF BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS ST LEGL -DESCRIPTION LOT NO 1e.� Q� � OWNER MAIL BLOCK TRACT ADDRESS NO OF BLDGS CITY TEL NO ` SIZE OF LOT p(/\ NOW ON LOT USE OF DISTRICT NO GROUP MAP BUILDINGS + �--� BK PG CONTRACTOR, 14 ADDRESS,j� �/ , �, CONNECTION DATA Zf CITY �< P /a1xv TEL NO " / STATION DEPTH Z ` ,..�/ MANHOLE REFERENCE L7 STATE LOWER REGISTRATION NO ❑ COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF CONNECTIO 1 LENGTH FROM / Y. CURB P' ,/ M L TOP L a� PUBLIC SEWER @ $3 50 d SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD @ $3 00 OVERFLOW SEEPAGE PIT DRAINFIELD P C NO EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO CON NECT ADDITIONAL BLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER @ $1 00 QD PERMIT NO ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL CHARGES _ CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEE 1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEW 41 NEW HOUSE SEWER SIGNED THIS DAY O ` 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS AGENT SEPTIC TANK,SEEP,PIT(S) ADDRESS f� i AND/OR DRAINFIELD 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑ 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 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND LICENSED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LE R OF THE ABOVE DESCRIBED RESIDENT ROPERTY� BACKFILL SEPTIC TANKS❑ OWN SIGNATURE SEEP PIT(S) ❑ CESSPOOLS❑ OF PERMITTEE JOHN A LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR CK N 0 CASH LT,0 4 0 9 2r* nto�r ? 5 .50 M COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1002180005 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (626) 285-0488 EXT , LEGAL ID ISEWER / SEPTIC SEWER BUILDING ADDRESS ITR 7690 LT 13 1EXIST OCC GRP 10516 DAINES DR I IBLDGS NOW ON LOT TEMP CA 917802812 1 (ASSESSOR INFORMATION NUMBER lCONNECTION TYPE NEAREST CROSS STREET HALIFAX 1 18586-029-017 (ORIGINATION THOMAS PAGE 597 GRID C3 LOCALITY TEMPLE CITY, Cl I ILENGTH ML TO PL STATION DEPTH ITENANT IMANHOLE REFERENCE 'UPPER/LOWER JISSUED ON PROCESSED BY EXPIRES ON 02/18/10 SR 02/18/11 I ICOUNTY IMPROVEMENT NUMBER I 10WNER TEL NO IPLAN CHECK NUMBER IFINAL DATE FINAL BY CODE 1 IGARIBAY, ROBERTO/IRMA (626) 452-8729- IJOB NUMBER I `Lt 110526 DAINES DR ITRUNK PERMIT NUMBER I e ti TEMPLE CITY CA 91780 IROAD PERMIT NUMBER IDESCRIPTION OF WORK IAFFADAVIT NO IREPAIR SEWER LINE WAIVER NO (APPLICANT TEL NO EASEMENT NO SAME AS OWNER IRECORD INSTRUMENT NBR RECORD DATE ISPECIAL CONDITIONS (HIGHWAY/STREET WIDENING I I STATE ENCROACHMENT PERMIT NUMBER I �I1 C 45 A tAfi 24-1 ICONTRACTOR TEL NO I FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER 1LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW HOUSE SEWER I I 1 101 PERMIT ISSUANCE FEE 27 75 ICONNECT ADDITIONAL I 1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 45 IBUILDING OR WORK 1ARCHITECT OR ENGINEER TEL NO I TOTAL FEES 58 20 I I , ISEPTIC TANK, SEEPAGE PITI 1 LIC NO I NAND/OR DRAIN FIELD 1 1 �IDRYWELL _ I t 1 SEWER MAP BOOK PAGE I (ALTER, REPAIR, SEWER OR 1 I SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND I I I 1ABANDON HOUSE SEWER I I BACKFILL SEPTIC TANKS ISEEP PIT _ CESSPOOL I I I I I I GRAYWATER SYSTEM I I 1 I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I (REPORT ID DPR266 ROUTE TO BS0508 I I I t , COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0110300004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: SEWER / SEPTIC: X BUILDING ADDRESS: TR: 7690 LT: 13 EXIST OCC GRP: 10516 DAINES DR BLDGS. NOW ON LOT: TEMP CA 917802812 ASSESSOR0 CONNECTION TYPE: NEAREST CROSS STREET: HALIFAX/PAL MAL 8586-029-017 ORIGINATION: THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED BY: EXPIRES ON: COUNTY IMPROVEMENT NUMBER: 10/30/01 JK 04/28/02 OWNER: TEL. PLAN CHECK NUMBER: FINALDATBY: . GARIBAY;ROBERTO (626) 452-8729- JOB NUMBER: 10526 DAINES TRUNK PERMIT NUMBER: TEMPLE CITY 91780 ROAD PERMIT NUMBER: CRIPTION OF WORK AFFADAVIT: NO INSTALL SEWER CLEANOUT WAIVER: NO TEL. EASEMENT: NO SAME AS OWNER - RECORD INSTRUMENT NBR: RECORD DATE: SP S: HIGHWAY/STREETsWIDENING:�4 STATE ENCROACHMENT;PERMIT�;NUMBER: CONTRACTOR: TEL. NO: S` AID APP 0INSPECTOR SIGNATURE SAME AS OWNER - 0, 17, LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW HOUSE SEWER Ar' 1� 01 PERMIT ISSUANCE FEE 27.75 —co—WET—ADDITIONAL T15 ALT/REP HOUSE'SEWER 1.00 EAC 30.45 BUILDING OR WORK ARCHITECT OR . NO: TOTAL FEES 58.20 SEPTIC TANK, SEEPAGE LIC. N0: illllll AND/OR DRAIN FIELD DRYWELL _ r— ER MAPBOOK: PAGE: r 1(1 n O L(�C W��1 SRI K ALTER, REPAIR, SEWER-0-F I I��`I fiJ4 (�`JJ} SEWAGE DISPOSAL SYSTEM �� ABANDON HOUSE SEWER WUrn n Y SEEP. PIT _ CESSPOOL _ GRAYWATER SYSTEM Service 1'Aa REPORT ID: DPR266 ROUTE TO BS0508