HomeMy Public PortalAbout10910 FREER ST_Sewer__ 75Aal
7SA642D APPLICATION FOR PERMIT
COUNTY OF LOS ANGM SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENCn(EER
BUELDING AND SAFETY DIVISION SUILDIRG
�
ADDRESS
nty Enablow
WMIJJAl+ JL A�Sur' A- LOCALITY �-
NE
OH GtAILEfT
F0'■
LEGAL
DEiCR1PTION LOT 110.
■AI L
BLOCK TRACT ADDRIM
/
SIS OR LAT 10040011,39'k
0.OR10OR13LOT •
USE 0 DISTRICT NO, GROUP ■." PROCESm IST
eul I w
H! Ps
CO■7YACTOII r
LUDDHJIIS COlQ�GTIO DATA
cnT TION DErrl A0 r
REGIfTRATIOR N D Z s ATE IANHOLt{REJ�twu
UATT
ry �1
ngffc CON(L DESCRIPTION OF )JORA F"
NNECTIRG To
TYPE OF w LDIGTH 140■
74- fEMC T 11((�f>EPAGE PR OR T. P.L. ■ TO P
PITS" RbILA1RFIELD
FL011 AGE Ptt RAlIPILLO L
0 fI 0011 E GTO P.C.■O. 0
0 00
CO.IMF.NO. JOB 110. U
SOCK THOU DLDG. R TRUNK PITT NO. ROAD MILIT■0. OC
00 1fia-A0 110USE ffATt ENCROACH■[IIT Q
MO P ■IT■0. L�Ji
INDUSTRIAL �
WAlTE AP to
Z
OWNEH"$ PEDQ't
CONNECTION CHAR"F0
AIITHOBMATIO 7OY At. REMBURfli■[NT nZ
1 HATE AT THIS DATE A CONTRACT WITH THE HIM III ED CDM-
TRACTOR TO CORIIEM.THE A110TE LLINQ AMOVALSDATE IN R m
TO THE PrUBLIC
SIGNED nY 9 NEN HOUSE SEWER � ` 7 ; x
OWN>QI04C0 Nr ADDInowA1
OWNERS AGLR ■GILDING OE WORK
f[PTICTANE 1SEP.PITS)
Al DRAT■Fl ELD
1 HST ACKNOWLEDGE THAT Y HAYS REkD SIS APPLICATION
AND STATE THAT THE ABOVE IB COAEECT AHD AGREE TO CO■FLT CE■SPOOL tj DRTWEL
WITH ALL coURTT ORDFwLRCE6 AND STATE LAWS REGULATING ALTER IUUA]R.SEWER 0■
PLUMBING AND SEN121. SEWAGE DISPOSAL FTMII
1 HEMET CERTI 1 Al P40PERLT REGISTEIIED AND/OR DISCONNECT PLUG AND
IJCENSM AS LOS MGHLES COUNTY M STATICOF ABANDON HOUSE SEWER
CALIFORNIA OR T I A■ THE IJIGAL YE
DKffr-RIBED ILPIRT. SACEFILL S£ TAIIKE
SEEP. T f C CE�00
SI GMTV Iti
OF PERM
ALIDA ROBERT A. WOOD
■ 0. Surx"LOIN0 URCHAHICAL ZHOMMM
-� UC63 3 6 2% AM22 1 0 D 7.00- 4
lam uuan
APPLICATION FOR PERMIT -
7u/410 COUNTY 0P LOS ANCEI.FS SEWER-SEWAGE .DISPOSAL
DEPAHTMCXT OF COUNTY EpiQn(M
iummwa AmD SAFETY DrimOn B U I Lp I N G
��.�•g�p �r ADDRESS
1L E JE�f, Bap' 41lRfldt.Q 'LOCAUTT r �� r
INFA
FOR APPLICANT TO ALL IN c o!S ST O
DESCRI�TI
LL{{GII1 L OR LUT X0. 'OWXE!
B L.00'[ TRACT � EIAI L
ADDREn
X10.OF p
InZf9 OF LOT NOW ON IAT CnT TEL No_
BUILDINGS dDISMtTNO. G U Bt !'iiCQNTUCTORADDRESa �CO O DAMCI TT 22 TEL NATION I)QTH
HAXHOLE RE LERCEREGISTRATION no. �0 - ��-
no D EE CRI pp ION R FEE
PUBLICS$Eti/ERCbnXECTInq TO ,QO
SEPTIC TANK,SEEPAGE P OR T. np CO E E.LI TO FRO
�� '
PIT$AND//OR DRAINFIELD -
0 LOW SEEPAGE PIT DRA1nF19LD
HOUSE SEWER CONSQMLN ECTST3TGTO P.C-�1b. '
4'O.IAF.NO. JOB 110.
CDNX
TIM BLAG,OR 'nWNX PERMIT NO. ROAD M MSFT NO.
WORK TO HOU SF�ER
DR ABANDON HOUSE1 STATE ENCYOACH*ENT Iq
P IT NO.
INDUSTRIAL
WASTE APPROVAL
CHARGES
OVMER's PgRMT 6011-NECTIOX CHARG FI$
AUTHO=AnON TOTAL FZ REIYBURSEYEf1T-FE�y - -
F MYB AT TI-WS DATI! A CONTRACT WITH 'THE HEREIN. nANED CON-
TCTOR 10 GONNE THE ABOVE DESCRIBED EIISTING DW-ELLING AMOY DATE IN$PHCTO
RAR'lSIGXJLTVRR
TO THE PUBLIC SEWER.
SIGNED THI F 9_ AM 9DUSE SEVER
OWNER OR CONNECT ADDITIONAL
OWNERSAGEICr BUILDING OR*ORI(
ADD E38 �B/R D W N F 15 LD
I HEREBY ACKR LEDGE TH T I HAVE READ TH{S APPLICA ION _ -•
AND STATE THAT TI3E ABOVE 1S' CORRECT AND A-0REE TE CO PLT CESSPOOL DRTWEL
WITH ALL COUMR ND1 CES AND STATE LAWS REGULATING ALTAR.REPA1ji,SEyfiR U
PLUROING AND $EWE.FLS. SE�IAGE DIS, ' STL
I HEREBY CERTIFY THAT I A■ PROPERLY REGIWE SHE ABp R DISCONNECT PLUG AND
UUMSED AS REO UI LOS ANQELES CO N N VA;;90F AHAXDON HOUSE SE1►E3t
CALIFORNIA OR TH LEGAL�1} OF VS
DESCRIBED RES1D PERT. /✓6/� C F LL IC TANKS '
31GNATURE IT / POOLS
OF PERRI i
�► VALEDATI ROBERT A. wood
C& a.a ( u ) SUPII"1140 .RN4IK=
Lko 3353u AM2211 D 25.00, .1 ,
COUNTY OF LAS ANGELES TEMPLE CITY i 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 1401140003
BUILDING AND SAFE'T'Y / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ETT:
LEGAL ID: SEWER / SEPTIC: SEWER BUILDING ADDRESS,
TR: 11497 LT: 2 BL: A EXIST OCC GRP: 10910 FREER ST
BLDGS. NOW ON LAT: TE?tp CA 917803540
ASSESSOR INF•ORMR=ON NUMBER: CO2ZN=ON TYP$: \ WFnnRaf` CROSS STREET: EL ►LINTS
8574-008-029 - ORIGINATION: THDMAS PAGE: 597 GRID: D4 LOCALITY: TEl,= CITY, C
LENGTH ML TO PL: STATION: DEPTH:
TE[UkNT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCFSSED BY:
01/14/14 SR
COUNTY IMPROVEM NT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FDOLL DATE FINAL BY: CODE:
BOYER, YOL.ANDA (626) 350-8355- JOB NUMBER: r J Z_n
10910 FREER ST TRUNK PERMIT NUMBER: I �(' � )/
TEMP 917803540 ROAD PERMIT NUMBER: D2SCRIPTION OF WORK
AFFADAVIT: NO REPLACE SEWER PIPE
WAIVER: NO
APPLICANT: TEL. B10: EASEMENT: NO
ARAM MADOIAN (818) 262-3604-
7949 AJAY DRIVE RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
SUN VALLEY CA 91352 FIIGENKY/STREET WIDENING:
STATE SNCROACHME PT PERMIT NUMBER:
Q
CONTRACTOR: TEL. NO: FEES PAID APPR:7VAL9 DATEV INSPECTOR SIGNATURE
M7PRE.SS PLUMBING AND ROOTER (818) 908-9583-
7949 AJAY DRIVE #{A LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEN HOUSE SEWER
SUN VALLEY CA 91352 796478
O1 PERMIT ISSUANCE FEE 27.80 CONNECT ADDITIONAL
15 ALT/REP ROUSE SEYRR 1.00 EAC 30.50 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. NO: TOTAL FEES 58.30
SEPTIC TANK, SEEPAGE PTT
LIC. NO: AND/OR DRAIN FIELD
DRYiCn L
SEWER IADP BOOK: PAGE: ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
ABANDON HOUSE SEWER
BACKFILL SEPTIC TAN" _
SEEP. PTT CESSPOOL
GRAYWATER SYSTEM
* ADDITIONAL DATA ON FILE
REPORT ID: DPR266 ROUTE TO BS0508