HomeMy Public PortalAbout5636 GRACEWOOD AVE_Sewer__ APPLICATION FOR PERMIT,
cOMY OF 108 ANCHU SEWER-SEWAGE DISPOSAL
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RESS
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HECTI G TO P.C.No.
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wou TO tffl E SwLDG.OR ` TRUNK PERMIT X0. ROAD PERIIT NO.
AI 0 M X HOUSE STATEiNCROACHRENT
00 PERMIT NO.
VDUSTRIAL
AM APPROVAL
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AUTHOHMTION TOTAL FM _RXIMBURs NIUff FTSE
I HAVE AT THIS DATE A CONTRACT WITH THE HERIIX NAMED COIF
TRACTOR TO CONNECT THE ABOYE D BED-¢STING DWELLIN9 AMOV DATE INSPECTOR'S SIGXArURI
TO THE PUBLIC
SIGNED TH T OF NEW HOUr[SEWER
OWNER OR - CONNECT ADDITIONAL n L
OWNERS AG BUILDING OR PORI(
ADp RTC
TAXC SEEP.PIT(S)
MD R DRAINFIELD
I HEREBT ACKNOWLEDGE THAT I HAVE READ THIS AFPLICATIOR
MD STATE THAT THE ABOVE IS CORRECT AND AGRIM TO CO■p LT CRJSPOOL DRTWE
WITH ALL COUNTT ORDINACES AND STATE LAWS RIGULATIXG REPAIR,SEWER OR
PLUMBING AND S[WERS. RIMA/U!�� ALTER,BIEWAOEPAIR,DISFOSESTR OR
LICHERENT ENSED ASREQUIREDIRED BT FY THAT LOS AAN NGELES PROPERLY
AND START [tmcimLL
N[CT PLUG AND
CALIFORNIA OR TTHHIlN� 1 AN THE LEGAL. OWNER OF THI ABOY[ N HOUSE SEWER
DESCRIBED RBlIDLIt C 7M[SSIGIUITURE ITS P00
OF PER■
L MAI. L 0. ROBERT A. WOOD
Q. 0. Cafi SIIJPlOtYli1NG1 H1L41iAN1CAl.1Q1/71liNXI
4 6 2 1 DEC 22 1 -0 A 3.0 Q n
-- L
COUNTY OF LOS ANGELES TEMPLE CITY 0508 SEWER PERMIT
DEPART?BNT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0907150003
BUILDING AND SAYRTY / LAND DEVELOPMENT TE[4PLE CITY CA 91780 -
PHONE: (626) 285-0488 ETT:
LEGAL ID: SEXIER SEPTIC: SEWER BUILDING ADDRESS:
ON FILE EXIST OCC GRP: 5636 GRACEWOOD AV
BLDGS. NOW ON LAT: ARCO CP. 910078411
ASSESSOR INFORMATION NWBER: CONNECTION TYPE: NEAREST CRASS STREET: LIVE OAK
8586-014-011 ORIG12aTTON: THOMAS PAGE: 597 GRID: B3 LOCALITY: TEMPLE CITY, C
LE93TH HL TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCE.9SED BY: ESPIRFS ON:
07/15/09 SR 01/15/10
COUNTY IMPROVE)CKNP NUMBER:
OWNER: TEL. NO: PLAN CHECI NUMBER: PIAL F77SAL Y: CODE:
ZHI CEM 2NANO (626) 446-6026- JOB NUMBER:
5636 GRNCWWDDD AV TRUNK PERMIT NUMBER:
TEMPLE CITY CA 91780 - ROAD PERMIT NUMBER: D CRI OF WORK
AFFADAVIT: NO CONNECT RESIDENCE TO PUBLIC SEWER
WAI=; NO
APPLICANT: TEL. NO: EASPI-=: NO
PAUL ROBERTS (626) 798-0725-
3228 ALANIUKEI) AVE. RECORD INSTRUM= NBR: RECORD DATE: SPECIAL COI.DITIONS:
RDBEMEAD, CA 91770 HIGHWAY/STREET WIDENING:
SLATE ENCROACHMENT PERMQT NUMBER:
CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
PAUL ROBERT'S (626) 798-0725-
MERCADO MANUEL LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW HOUSE SEIBI2
3228 Ai.A NIS AVENUE 839456 C42
ROSEMEAD, CA 91770 01 PERMIT ISSUANCE FEE 27.75 COQNFSCr ADDITIONAL
03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK
ARCHITECT OR ENGTWRTM: TEL. N0: 04 TAP 4 SADDLE 231.00
- TOTAL FELr9 305.70 SEPTI TANK, SEEPAGE PTT
LIC. NO: AND/OR DRAIN FTSLD
DRYWELL
SEWER MAP BOOK: PAGE: JJJ ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM
DISCCINNE:CT PLUG AND
AHAND0N HOUSE SEWER
BACIFELL SEPTIC TANKS _
SEEP. PTT CESSPOOL
G A.YNATER SYSTEM
REPORT ID: DPR266 ROUTE TO B80508