HomeMy Public PortalAbout9908 DAINES DR_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1301220014
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID ISEWER / SEPTIC SEWER . . I BUILDING ADDRESS- 1
ITR 13805 LT 83 (EXIST OCC GRP-
( 9908 DAINES DR 1
I IBLDGS NOW ON LOT TEMP CA 917802638 1
(ASSESSOR INFORMATION NUMBER ICONNECTION TYPE NEAREST CROSS STREET: 1
18588-018-015 (ORIGINATION. I THOMAS PAGE 597 GRID. A3 LOCALITY TEMPLE CITY CAI
I ILENGTH ML TO PL STATION DEPTH
ITENANT IMANHOLE REFERENCE UPPER/LOWER: (ISSUED ON PROCESSED�BY I
1 101/22/13 SR
ICOUNTY IMPROVEMENT NUMBER
(OWNER TEL NO IPLAN CHECK NUMBER: IFINAL PATE FINAL BY CODE
IDOWLING, SCOTT - IJOB NUMBER I -
19908 DAINES DR ITRUNK PERMIT NUMBER
(TEMP 917802638 IROAD PERMIT NUMBER ESCRIPTIO WORK
VE "VIT (REPLACE 4CLAY SEWER LINE AND PUT IN 4" CLEAN OUT
I 1WAIRNO I
I - I
1APPLICANT TEL NO. 1EASEMENT NO '
IWISEMAN, NICK_ (626) 500-8999-
1534 S ELWOOD #B IRECORD INSTRUMENT NBR RECORD DATE ISPFCIAL CONDITIONS 1
GLENDORA CA 91741 - (HIGHWAY/STREET WIDENING
STATE ENCROACHMENT PERMIT NUMBER
ICONTRACTOR TEL NO I FEES PAID 1APPROVALS - DATE /INSPECTOR SIGNATURE 1
IROOTER HERO PLUMBING INC (626) 500-8999- 1
1534 S ELWOOD #B LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INE➢. HOUSE SEWER I _
IGLENDORA CA 91741 973014 * I I ' I I I
1 101 PERMIT ISSUANCE FEE 27.80 ICONNECT ADDITIONAL I 1
1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 50 IBUILDING OR WORK I I 1
1ARCHITECT OR ENGINEER TEL NO I TOTAL FEES 58 30 1 r
LIC NO I ISEPTIC TANK, SEEPAGE PITI I
1AN6/OR DRAIN FIELD I I
I i IDRYWELL _ I I
I
SEWER MAP BOOK PAGE 1 ALTER, REPAIR, SEWER OR I I
1 i ISEZlAGE DISPOSAL SYSTEM
I I I
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IDIFCONNECT PLUG AND I I
1ABAN60N HOUSE SEWER I I
I IBACKFILL SEPTIC TANKS
I 1SEEP PIT _ CESSPOOL
I I IGRAYWATER^SYSTEM 1
1 I I I I I
I I I I I I• _ I
1 1* ADDITIONAL DATA ON FILE I I I I
_ IREPORT ID DPR266 - ROUTE-TO BSO508 1
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epaYmentofounty ngIaeer '—
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' DESCRIPTION, -'LOT NO�.�c,' •�t7f•� i• 'r, •� _ OWNER_
TRACT�: �,i �" n , & P ADDL _+
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a NCO. OF BLDGS.
r SIZE OF LOT �//°- NOWON�LOT` �:..,'�a^:rl+ ' -aS -CITY and TEL 'NO.
3 BUILDINGS`• .i/ ��h! ar •s DISTRICT'NO.. �GROUP�i f`'+`"IAAP•";
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s CONT,!ACTOR
A��REss 3, CONNECTION DATA
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CITY•f iP� r _TEL.00. r ,�`•�/ STATION ,�pjy � DEPTH t
,""' ."• S '�`{ 1_ �' -,`�• tr � L�"31•ICTEa.,� .'MANHOLE REFERENCE o� .rte eCU PPER �t
'REGISTRATION5NO'` J �� _ �0 .,COUNTY E NER'�.
����. POW .'Y Y •:&� ��` we.Y,.v�.,35q. 1 t + d -
No . SCRIPTION,OF�WORK , F E;,a ,
HOUSE SEWER�CONNECTING TO'�` - .E b, - Y TYPE-OF�CONNECTION LENGTH FROM �-7,
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PUBLIC SEWER _ S'-3 50 £� _ �_ _�.H� �f CURB P L M L TOP L
}HOUSE'SEWER-CONN ECTINGJOA._'^F •�: ,_ `l•�.
'a •BPRIVATE DISPOSAL SYSTEM ` " •1 00 .g
lCONNECT ADDITIONAL BLDG.-OR' - r a'i v. "'�"— '} *� P C NO
' '• fWORK TO HOUS&SEWER,, '^ ir^ 'I 00; •?,a ,�" CO ig{IMP NO' S / /� JOB NO• '
+•` !ALTER,OR,REPAIR^EXISTING�� .;,,, �,.,, '• _ ����
1 SEWER OR DISPOSAL SYSTEM` 1.00 r ` �FTRUNK PERMIT NO ROAD PERMIT N0.
1 DISCONNECT AND'A'BANDON SEWER' 's,
'
AND/,OR:DISPOSAL•SYSTEM .�, 's .1-00 �. 's. a'a _ tP RLLIZ-IQO^`,•
SEPTIC-TANK• INDUSTRIAL
SEEPAGE PIT,OR<,
PITS'AND/OR(DRAINFIELD^ _ , _ __ '2 00 , •� ' +
WSSPOOL,•-DRYWEL'L;+ ^" ? '°•' ". WASTE APPROVAL
SPECIALCONDITIONSONLY°,,, v: g `2 00 a«, .. -� ._a CHARGES -
MIT „ CONNECTION CHARGE FEE
OW ''NER'S
�.�. .:�� 'I q0
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AUTH(5_MZATIOj a 6%v °TbTAL"FEE• .+-, -�i REIMBURSEMENT FEE
:�•s -$-eN�'Y 4 ,.^ y 7 _, c r _ •
�I +HAVE;,THIS DATE,CONTRACTED,WITH^'THE HEREIN NA EDrCON``; '
'TRACTOR,TO`CONNECT•THE ABO%E'DESCRISED,EXISTING;,DWELLING", APPROVALS DATE INSPECTOR'S SIGNATURE
>a.TO'THE,IP,UBLIC,tSEK'ER•,�.(g,, _,;,,-0i I 'S - w•o._..•,.-.,�.. .. .___.
SIGNED-THIS* -°DAY,OF �g rNEw HousE sEwER
_ t
' `H'�v '' •'a„ ` k ” ' •CONNECTADDIT101NAL -
OWNER OR �.t `" s _ 'r �'�" " BUILDING OR WORK
aOWNERSy _....,.�....
.A v- - w : 'wcrS,. =+• '.�'-��-.A+-r'�k•-a Zy� #SEPTIC+. AT NK;,SEEP:*PIT•(S;p..�,w..
ADDRESS '"•-" "`" ',AND/OR DRAINFIELD
;I HEREBY, ACKNOW,LEDGE_THATe Ia;HAVE`•READQTHIS,.AP,P•LICATION., .CESSPOOL B•-DRYWELL 3•--^*r-• - ' '� ti
AND-STATE THAT 7,H E}ABOVE'•IS'.CORRECT,,ANDA:GREE;TO COMPLY ,
# WITH ALL COUNTY ORDINANCES AND STATE,LAWS REGULATING ALTER„REPAIR.SEWER OR_�
PL'UMBING'AND'SEWERSt-:.n '..'f«w�-;.�-'s+...r-,^-"�F;`
SEWAGE DISPOSAL SYSTEM
+ ,'•1'•HEREBY CERTIFY THAT-di AM,-PROPERLY• REGISTERED, AND/,OR
,LICENSED•AS,REQ,UIRED„+BY,•LOS;,ANGELES,COUNTY-AND'-[,STATE.OF, ,DISCONNECT'PLUG,AND._,
CALIFORNIA.,OR' THAT+'1 AM=,THE TEGAL, OWN OF,?THE•ABOVE, tABANDON HOUSE SEWER
a'' 4°DESCRIBED RESIDENTIAL” PR RTY:•.. ,,,BACKFILL SEPTIC17ANK5,❑
-�' „,s >_.._ •,,.., ..y__•...(f.�,. ..J.- SEEP. PITS) ❑ CESSPOOLS �I�-1 _X
SIGNATURE * a _ .. .,...�..,,.•.- ,t, - .
OFdPERMl11TEE
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