HomeMy Public PortalAbout9328 DAINES DR_Sewer__ IDEPAICrMENT OF COUNTY ENGINEER SEWER-SEWAGE- DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENmNEER I BUILDING p D
ADDRESS CJ
FOR APPLICANT TO FILL IN LOCALITY Te M,6 C,
BUILDING NEAREST
ADDRESS 9328 Daines DriveCROSS ST. ,
LOCALITY Temple City, -Calif. DISTRICT NO. SERIAL NO. PERMIT NO.
NEAREST .5 A 3,3 <6 7j /D 7 S
CROSS ST.
RECEIV�D B,Y Ready for Inspection DATE ISSUED
OWNER Mobile Homes Co. -3 -53
MAIL
ADDRESS 2612 No. Rosemead Blvd. USEZONE OCCUPANCY MAP,
BK PG
CITY El Monte.,Ci+allf.. TEL.NO. e
CONTRACTOR BURKE—HOIKARD
CO.IMP.N0.
ADDRESS 26.36 No. Rosemead Blvd.
JOB N0.
CITY El Monte TEL.NO,
❑❑ TRUNK PERMIT NO.
REGISTRATION NO. 3792 B ❑ COUNTY
ROAD PERMIT N0.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0.
PERMIT N0.
BLOCK TRACT INDUSTRIAL .
WASTE APPROVAL
SIZE OF LOT N0.9F BLOGS.
NOW ON LOT CHARGES
USE OF
BUILDINGS Dwelling CONNECTION CHARGE FEE-
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
l PUBLICSEWER @ $ 3.50 3_ 0 RECEIPT NO. I e DATEy I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO- 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 2 S� DEPTH.
CESSPOOL—D RYW ELL
SPECIAL CONDITIONS ONLY 2.00 n r ) MANHOLE REFERENCE
UPPER COWER?
TYPE OF CONNgJVION LENGTH FROM �1
OWNERS PERMIT $ 1 00 Y. evfle P.L. M.L.TO P.L. S
AUTHORIZATION I TOTAL FEE 4 50
1HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING' APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS-----_--------------DAY OF..........................._......__.19_._._ 'NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT--------------------------------------•----------------------_---- BUILDING OR WORK
.__.-_-_.___ SEPTIC TANK,SEEP.PIT(S)
ADDRESS..................................
___..._-_-_-.-_..___..._-__.__........._-. AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT IHAVE 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 DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOPLUGAND
AND STATE OF CALIFORNIA OR THAT 1 AM THE EGAL OWN-
ER OF THE ABOV DESC BED IDENTIAL PERTY. BACKFILL SEPTIC TANKS
SIGNATURE y SEEP.PIT(S)[] CESSPOOLS E:]OF PERMITTEE-------.-.----------- -•---.__-_.
76AG42D 663 1/53
EPAR71MEN1n OF COUNTY ENGINEER SEWER—SEWAGE DISPOSAL
. +wAI-l.ZISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF HAS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER BUILDING
CASSATT D. GRIFFIN. SUPIT.DF BUILDING I ADDRESS
FOR APPLICANT TO FILL IN LOCALITY
BUILDING NEAREST
ADDRESS 9328 Daines Dr. NEAR ST.
LOCALITY DISTRICT NO' SERIAL NO. PERMIT NO.
Temple Citg9 Calif, �� A S
NEAREST
CROSS ST.
RECE ED BY Ready for Inspection DATE ISSUED
OWNER Mobile Homes Co.MAIL
�
ADDRESS El Monte, California BK PG
USE ZONE OCCUPANCY I MAP
CITY TEL.NO.
CONTRACTOR Burke—Howard CHARGES REIMBURSEMENT FEE
ADDRESS 2.36 No. Rosemead Blvd* REQUIRED
NOT REQUIRED
CITY El Monte, Calif UL-NO. JOB.NO. CONNECTION CHARGE FEE
REGISTRATION NO. 3?'92 STATE
COUNTY CO.IMP. N0.
LEGAL RECEIPT NO. I DATEI BY
DESCRIPTION LOT N0.
BLOCK TRACT WAIVER FOR RECORDING
SIZE OF LOT NO.OF BLOCS.
NOW ON LOT RECEIPT N0. I DATE BY
USE OF
BUILDINGS
- TRUNK PERMIT NO.
N0. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ROAD PERMIT NO.
PUBLIC SEWER @ $ 3.50
HOUSE SEWER CONNECTING TO 1 00 STATE ENCROACHMENT
1 PRIVATE DISPOSAL,SYSTEM 1.00 PERMIT NO.
CONNECT ADDITIONAL BLDG.OR INDUSTRIAL
WORK TO HOUSE SEWER 1.00 WASTE APPROVAL
ALTER OR REPAIR EXISTING
SEWER OR DISPOSAL SYSTEM 1.00 CONNECTION DATA
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 STATION DEPTH
1
PITS AND/OR RAINFGELDTOR 2.00 �Ei
OO
MANHOLE REFERENCE
CESSPOOL—DRYWELL UPPER LOWER
SPECIAL CONDITIONS ONLY 2.00 TYPE OF CONNECTION LENGTH FROM
Y. CURB P.L. M.L.TO P.L.
OWNERSI PERMIT $ 1 00
AUTHORIZATION TOTAL FEE 4 h
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'SSIGNATURE DyA'
DWELLING TO THE PUBLIC SEWER _TE
SIGNED THIS--------------------DAY OF-----------............................ 19NEW HOUSE SEWER
OWNER OR --------
CONNECT ADDITIONAL_
�OWNERS AGENT------------------------------------------------------------------------- BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS - ............................................. AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CESSPOOL[] DRYWELL❑ \� n
CATION AND STATE THAT THE'ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORD ES AND STATE LAWS
E
TER,REPAIR SEWER �^
REGULATING PLUMBING AND S WAGE DISPOSAL SYSTEM1HEREBY CERTIFY ROPERLY REGISTERED wAND/GR LICENSED Q BY LOS ANGELES COUNTY - SCONNECT PLUG AND ¢� I�AND STATE OF OR THAT I AM THE LEGAL OWN• ANDON HOUSE SEWER / �V� k 4
ER OF THE C IBE RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS �Sd"
C� ° °° SEEP.PIT(S)[] CESSPOOLS❑ �,
SIGNATUEiE °•'•°
OF PERMITTEE-_ x�°'-----,.--
76A642D 66.3 2..•'O