HomeMy Public PortalAbout9850 DAINES DR_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0209110002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: SEWER / SEPTIC: X BUILDING ADDRESS:
TR: 13805 LT: 81 EXIST OCC GRP: 9850 DAINES DR
SLOGS. NOW ON LOT: TEMP CA 917802636
ASSESSORCONNECTION TYPE: NEAREST CROSS STREET: BALDWIN AVE
8588-017-018 ORIGINATION: THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
EN MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: .
09/11/02 JK 03/10/03
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY' CODE:
DAO;JENNIFER (626) 375-3313- JOB NUMBER:
9850 DAINES DR TRUNK PERMIT NUMBER: 1 O�
TEMP 917802636 ROAD PERMIT NUMBER:
DESCRIPTION Or-PURT--
AFFADAVIT: NO REPLACE SEWERLINE
WAIVER: NO
APPLICANT: EASEMENT: NO
WAI TAK CONSTRUCTION (626) 285-7931-
611 E MISSION RD RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
SAN GABRIEL HIGHWAY/STREET�--WIDENING:���
STATE ENCROACHMENT-PERMITLNUMBER:-
CONTRACTOR: TEL. NO: �� �;, Y --,F PAID APPROVALS NSPEC OR S GNA E
WAI TAK CONSTRUCTION (626) 285-7931-
-Z
\
611 E. MISSION RD. LIC. NO FEE DESCRIPTION: QUANTITY': UOM: AMOUNT: E
SAN GABRIEL, CA 91776 586138 B %77 /j"' �� ' Z
01 PERMIT ISSUANCE FEE) \ 27.75 CONNECT ADDITIONAL
03 CONN�TO�PUBLIC'ySEWER - 1.00 CONS 46.95 BUILDING OR WORK
ARCHITECT „� , �n�(1.� ' TOTAL FEES \ 74.70
, SEEPAGE PIT
LIC. N0./( _ f ,� AND/OR DRAIN FIELD
i �-`�1
DRYWELL _
SEWER MAP B00 PGE: 1 r� �,i",� ^/� �� ALTER, REPAIR, SEWER OR
{--a ' � �i� l�,l��� �,
V,j I����� �� ����� �� SEWAGE DISPOSAL SYSTEM
- -- -- - - - - -- - - - DISCONNECT PLUG
- - / ABANDON HOUSE SEWER
BACKFILL SEPTrC
SEEP. PIT _ CESSPOOL _
GRAYWATER SYSTEM
REPORT ID: DPR266 ROUTE TO BS0508
DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY i PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY ENGINEER I BUILDING
ADDRESS J
FOR ARPLICANT T LL IN LOCALITY
BUILDING NEAREST
ADDRESS rJ � !J ���(((/// J���� -�,.���� CROSS ST.
LOCALITY DISTRICT 0. Ready for Inspection I M
IT NO.
NEAREST
3 s
CROSS ST. A /'( (
RECEIVED BY ; DATE I ISSUEDY ,l%� DATE
OWNER Dmf 'R/�^�/�l
MAIL
ADDRESS USE ZONE OCCUPANCY MAP
BK
CITY PG
�v✓L�'• `
TE p0. �j
CONTRACTOR CO.IMP-N0. 14 76
ADDRESS SIQ 4 r ) JOB.NO.
CITY` TEL.NO. TRUNK PERMIT NO.STATE
_1
REGISTRATION NO. r ? b g 8 COUNTY ROAD PERMIT NO. -:2 -7 O
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT NO.
BLOCK TRACT WARI
WASTE APPROVAL �—
SIZE OF LOT NO.OF BLDGS. CHARGES
NOW ON LOT
USE OF
-BUILDINGS /.'P�t� a� �, ; CONNECTION CHARG FEE
NO. DEStFfIPTION OF W13RK `FEE
REIMBURSEMENT FEE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER @ $ 8.50 Q RECEIPT N0. I DATE I BY
HOUSE SEWER CONNECTING TO ;
_ PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR. //�� CEP ON RECORDED
WORK TO HOUSE SEWER Lt. L_004 IDATE BY
ALTER OR REPAIR EXISTING
_ SEWER OR DISPOSAL SYSTEM I
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1.00 CONNECTIO DATA
SEPTIC TANK.SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION �" 9�Q DEPTH
CESSPOOL—DRYWELL 1
SPECIAL CONDITIONS ONLY 2.00 / lal MANHOLE REFERENCE LOWER
-TYPEQFCOM#IWECTION LENGTH FROM
OWNERS PERMIT ; I Y. ( CURB) P.L. M.L.TO P.L.
AUTHORIZATION TOTAL FEE
I HAVE THIS DATE CONTRACTED W HE HEREIN NAMED
CONTRACTOR TO CONNECT THE A VE DESCRIBED EXISTING APPROVALS INSPECTOO SIGNATURE DATE
DWELLING TO TpH7EUBLIC SEW '��SIGNED THISZ _DAY F -� 19?Y EW HOUSE SEWER
OWNER OR / CONNECT ADDITIONAL
OWNERS AGENT......_ _ / i BUILDING OR WORK
SEPTIC TANK.SEEP.PIT(S)
ADDRESS..._.._..�� _. .c.f..l. _.. _.. AND/OR DRAINFIELD
I HEREBY ACK LEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL[-] DRYWELL
CATION AND STA 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 I AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBWRESENTIAL PROPERTY. BACKFILL SEPTIC TANKS
SIGNATURE SEEP.PIT(S)E] CESSPOOLARST
OF PERMITTEE__
76A642D S&E 663 4/54 1