HomeMy Public PortalAbout9068 EMPEROR AVE_Sewer__ D
S&E 683 I1-58
APPLICATION FOR PERMIT 1
8&E 6
DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL
Deportment of County Engineer
County of Los Angeles BUILDING
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS
® CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY 541
FOR APPLICANT TO FILL IN CROSS s
LEGAL
DESCRIPTION LOT NO OWNER
/ O MAIL
BLOCK TRACT ADDRESS -
NO OF BLDGS
SIZE OF LOT-70 NOW ON LOT CITY TEL NO
USE OF
BUILDINGS DISTRICT NO GROUP MAP
CONTRACTOR r I BK P
ADDRESS �1 '����a f �� II CONNECTION DATA
/ STATION l'f'" DEPTH
CITY - /B EL NO /� MANHOLE REFERENCE UPPER
REGISTRATION NO
o�� ❑ COUNTY o
NO DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNEC710 LENGTH FROM
Y CURB P L M L TOP L
PUBLIC SEWER @ $3 50
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 ��O I JOB NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO /
CONNECT ADDITIONAL BLDG OR STATE EN ROACHMENT
WORK TO HOUSE SEWER @ $1 00 PERMIT NO
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL
__C ARGES
CONNECTION CHARGE F -
OWNER'S PERMIT $ 1 00 -
AUTHORIZATION TOTAL FEE REIMBURSEMENT E
�a
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING _
TO THE PUBLIC SEWER NEW HOUSE SEWER `
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL
OWNER OR `r BUILDING OR WORK
OWNERS AGENT �j e'� �`'J SEPTIC TANK,SEEP, PIT(S)
ADDRESS 9d��1 -- �'�'6/' AND/OR DRAINFIELD -
I EDGE 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_
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF AND
ABANDON HOUDISCONNECT PLUG LUGSE AND _
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI PROPERTY BACKFILL SEPTIC TANKS[]--,j 7 /� LI
SIGNATURE SEEP PIT(S) ❑ CESSPOOLS _�i .
17
OF PERMITTEE
JOHN A LAMBIE COUNTY ENGINEER .VALIDATION ROBERT"A WOOD CHIEF PLBG INSPECTOR
`K I�y , 6A
4 u-, RAR14 4 4.5 0 '�
COUNTY OF LOS ANGELES TEMPLF CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1401270002
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
ILEGAL ID ISEWER / SEPTIC SEWER I BUILDING ADDRESS I
ITR 12504 LT 35 BL 001 IEXIST OCC�GRP I 9068 EMPEROR AV I
IBLDGS NOW ON LOT I SGAB CA 917752066 I
(ASSESSOR INFORMATION NUMBER ICONNECTION TYPE NEAREST CROSS STREET
15382-018-022 (ORIGINATION THOMAS PAGE 596 GRID H1 LOCALITY TEMPLE CITY CAI
(LENGTH ML TO PL STATION DEPTH
ITENANT IMANHOLE REFERENCE UPPER/LOWER (ISSUED ON PROCESSED BY I
I 101/27/14 SR
ICOUNTY IMPROVEMENT NUMBER I I
(OWNER TEL NO IPLAN CHECK NUMBER IFINAL DATE FI AL BY CODE
ICHING, SUNNY (626) 947-1858- IJOB NUMBER I I
12718 BRADFORD AV ITRUNK PERMIT NUMBER I
IARCD 910078401 ,(ROAD PERMIT NUMBER IDESCRIPTION OF WORKI
I IAFFADAVIT NO (REPAIR SEWER LINE IN FRONT HOUSE I
I _IWAIVER NO I
(APPLICANT TEL NO !EASEMENT NO
ILUU, DONG P (626) 831-3561- 1
12108 PENNSYLVANIA AV ';RECORD INSTRUMENT NBR RECORD DATE ISPE�-IAL CONDITIONS I
COLTON CA 92324 IHIGHWAY/STREET WIDENING I 1
ISTATE ENCROACHMENT PERMIT NUMBER I I
ICONTRACTOR TEL NO FEES PAID (APPROVALS DATE INSPECTOR SIGNATURE 1
IDONG PHU LUU (626) 448-3562- 1 1
12108 PENNSYLVANIA AVE LIC NO IFEE DESCRIPTION QUANTITY UOM AMOUNT INEW ,{OUSE SEWER I I
ICOLTON CA 92324 654302 * I 1
1 101 PERMIT ISSUANCE FEE 27 80 ICONNECT ADDITIONAL I I I
1 115 ALT/REP HOUSE SEWER 1 00 EAC 30 50 IBUI-DING OR WORK
(ARCHITECT OR ENGINEER TEL NO TOTAL FEES 58 30 1 I 1
- ISEPTIC TANK, SEEPAGE PITI
1 LIC NO IAND'OR DRAIN FIELD I I
I I I I I 1
1 DRYLIELL _
1 SEWER MAP BOOK PAGE I IALTFR, REPAI , SEWER OR
ISEWAGE DI SAL SYSTEM
IDIS,ONNECT PLUG AND I 1 I
IABAADON HOUSE SEWER I I I
I I_{ I I I
IBAC}FILL SEPTIC TANKS
I 1SEEr PIT _ CESSPOOL _ I
1GRAYWATER SYSTEM 1
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* ADDITIONAL DATA ON FILE I I I
IREPORT ID DPR266 ROUTE TO BS0508 1 I