HomeMy Public PortalAbout9836 FLAHERTY ST_Sewer__ COUNTY-OF LOS ANGEI.ES- TEMPLE CITY # 0508 SEWER PERMIT
•DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0506 0510060001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID SEWER / SEPTIC: SEWER BUILDING ADDRESS:
TR. 14063 LT: 10 EXIST OCC GRP: 9836 FLAHERTY ST
BLDGS. NOW ON LOT: TEMP CA 917801710
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: GOLDEN WEST
5385-026-023 ORIGINATION: THOMAS PAGE:, 597 GRID: A2 LOCALITY- TEMPLE CITY, C
LENGTH ML TO PL: STATION: DEPTH
TENANT- MANHOLE REFERENCE: UPPER/LOWER- ISSUED ON: PROCESSED BY: EXPIRES ON:
10/06/05 JK 04/04/06
COUNTY IMPROVEMENT NUMBER-
OWNER. TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY. CODE:
YAN, ERIC (626) 29172130- JOB NUMBER. &�j�/� _
9836 FLAHERTY ST TRUNK PERMIT NUMBER: /fi�/� /
TEMPLE CITY ROAD PERMIT NUMBER: nESCRIPTION OF WORK
AFFADAVIT: NO CONNECT SEWER LINE
WAIVER: NO
APPLICANT TEL NO: EASEMENT' NO
SAME AS OWNER -
RECORD INSTRUMENT NBR• RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIDENING:
STATE ENCROACHMENT PERMIT NUMBER:
CONTRACTOR TEL NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT NEW HOUSE SEWER
O1 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL
03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL NO- TOTAL FEES 74.70 J
TAI, CLEMENT (626) 286-0079- SEPTIC TANK, SEEPAGE PIT
9552 WENDON ST LIC. NO AND/OR DRAIN FIELD
TEMPLE CITY CA 91780 NONE -
DRYWELL
SEWER MAP BOOK: PAGE: - ALTER, REPAIR, SEWER OR -
SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
ABANDON HOUSE SEWER
• BACKFILL SEPTIC TANKS_
SEEP. PIT CESSPOOL ._ - - -
GRAYWATER SYSTEM
REPORT ID: DPR266 ROUTE TO - BSO508
E-6D
S @ APPLICATIONFOR PERMIT 1
9 •68DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL.
Department of County Engineer
County of LOS Angeles BUILDING
JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS
® CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY I' A4
"
FOR APPLICANT TO 'FILL IN CROSS T.
LEGAL OWNER* ZA
DESCRIPTION LOT NO. MAIL
BLOCK TRACT I
l �— V-4 6 ADDRESS
NO. OF BLDGS. CITY TEL. NO. ��j
SIZE OF LOT NOW ON LOT i46
USE OF
BUILDINGS DISTRICT NO. GROUP MAP
,.
os n B K PG
CONTRACTOR
ADDRESS CONNECTION DATA
If �3 �.
STATION � DEPTH
CITY' TEL. NO.
MANHOLE REFERENCE k UPPER
TATE
REGISTRATION NO. ❑ COUNTY
NO. DESCRIPTION 01F WISRK FEE
Q
HOUSE SEWER CONNECTING TO TYPE OF N CTION LENGTH FROM t!- Y. URB P.L. M.L. TO P.L.
PUBLIC SEWER @ $3.50 _
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR,DRAINFIELD @ $3.00 S
OVERFLOW SEEPAGE PIT, DRAINFIELD CO. IMP. NO. 13 3 JOB NO
EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2.00
HOUSE SEWER CONNECTING TO - I`�
PRIVATE DISPOSAL SYSTEM @ $1.00 TRUNK PERMIT NO. ROAD PERMIT NO., `
CONNECT ADDITIONAL BLDG OR _ STATE ENCROACHMENT
WORK TO HOUSE SEWER @ $1 00 PERMIT NO. -
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL -
SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL '
CHARGES
CONNECTION CHARGE FEE
OWNERS PERMIT g 1 00
AUTHORIZATION TOTAL FEEREIMBURSEMENT FEE
O
I HAVE AT THIS DATE A CONTRACT WITH THE REIN NAMED CON-
APPROVALS DATE INSPECTORS SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING � 1
TO THE PUBLIC SE,W NEW HOUSE SEWER b�) j/l.�t���
SIGNED THIS DAY OI(r 19 �C CONNECT ADDITIONAL /
OWNER OR BUILDING OR WORK
OWNERS AGENT SEPTIC TANK,SEEP, PIT(S) _
ADDRESS / AND/OR DRAINFIELD -
1 HEREBY ACKNO L GE THAT VjXfF REA6 THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS 490RECT 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 DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA R THAT L AM T E LEGAL OWNER THE ABQQy�En
I D R EN PR PE BACKFILL SEPTIC TANKS❑ �( -r "
• SEEP. PIT ❑S) CESSPOOLS IL's,' p-
OF PERMITTE
JOHN A. LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A. WOOD, CHIEF PLBG. INSPECTOR
` CK. M.0. CASH
< �0 3 2 1 0 QC7 1 1 4 450 0