HomeMy Public PortalAbout4810 HALLOWELL AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
COUNTY OF LOS ANGELES
WILLIAM J. FOX, COUNTY EN131NEER I BUILDING
ADDRESS
!WT NG
LOCALITY
ADDREBUILDSS !W/� CREAREST
OSS ST. f J Oa ����2�4
LOCALITY DISTRICT NO. SERIAL NO. PERMIT N
NEAREST _�
CROSS ST.
REC IVE BY Ready for Inspection D TE ISSUED
OWNER Z p / S
MAIL
ADDRESS USE ZONEV OCCUPANCY .. BK M P PG
CITY TEL.N
CONTRACTOR ` ! ji.1 CO.IMP.N0.
ADDRESS ;' �:_ . JOB.NO.
CITY '( `,/ _ TEL:NO:'. G1 l J TRUNK PERMIT N0.
REGISTRATION NO �_ COUANTY ROAD PERMIT NO.
LEGAL �' �'� / STATE ENCROACHMENT
DESCRIPTION 0 0. j / PERMIT NO.
BLACK TRACT / ��C/`* _ INDUSTRIAL
ygSTE APPROVAL
SIZE OF L015-0)(/7j N0.OF BLDGS.
NOW ON LOT CHARG S
USE OF
BUILDINGS CONNECTION CHARGE F
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO REIMBURSEMENT FEE
PUBLIC SEWER Q $ 3.50 4 RECEIPT NO. DATE I BY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EXCEPTION F4CORDED
_ WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING / NO. DAT! I BY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
AND/OR DISPOSAL SYSTEM 1.00 _ CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR I
PITS AND/OR DRAINFIELD 2.00 l_ STATION 1742-3 DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 MANHOLE EFERENCE
LOWER
TYPECTION LENGTH FROM �r
4WDC RB Cot. M.L.TO P.L.
OWNERS PERMIT $ 1]ED
AUTHORIZATION TOTAL FEE —
I HAVE THIS DATE CONTRACTED WITH THE HEREIN N
HAVE
TO CONNECT THE ABOVE DESCRIBED EXIAPPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWERw-
�77 .DAY OF..: �FY_:___ NEW HOUSE SEWER
SIGNED THIS.�-.l-........ _.._____._1 . sG '✓n c
OWNER OR ��}.-' CONNECT ADDITIONAL
OWNERS AGENT. f'L•v- BUILDING OR WORK
ADDRESS.---..! � ._.-F .4.:fd s.7 �dt4'G--C.._.._........... .. SEPTIC TANK,SEEP.PIT(S)
AND/OR DRAINFIELD
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS • CESSPOOL DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATES ALTER.REPAIR.SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM
1 HEREBY CERTIFY THAT I AM PROPERLY REGISAND/OR LICENSED AS REQUIRED BY LOS ANGELES CDISCONNECT PLUG AND
AND STATE OF CALfF RNIA OR THAT I AM THE LEGAL • ABANDON HOUSE.SEWER
ER OF THE ABOVE SCRIBED RESIDENTIAL PROPERTBACKFILL SEPTIC TANKS
SIGNAToOF/ � , /,, SEEP.PIT(S)o CESSPOOLSOF PERMITTEE.------'.1.._6.5 `.e `.=s=- �:.....-
76A642A 663 7/53 fit!'
,. COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEW_ER :PERMIT-
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SE 0508_9809030009
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: SEWER / SEPTIC: X BUILDING ADDRESS.:
TR: 13645 LT: 13 EXIST OCC GRP: 4810 HALLOWELL AV"
BLDGS. NOW ON LOT: TEMP CA 917803456
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: LOWER AZUSA
8585-017-017 ORIGINATION: THOMAS PAGE: 597 GRID: C5 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED BY: EXPIRE ON:
09/03/98 UT09/03/ 9
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY:
BITTER RONALD M;CATANZARO TANYA L (626) 442-8837- JOB NUMBER:
4810 HALLOWELL AV TRUNK PERMIT NUMBER: ,�
91AA
TEMP 917803456 ROAD PERMIT NUMBER: DESCRIPTION OF WORK
AFFADAVIT: NO EXTEND=SEWER LINE TO REAR OF PROPERTY FO FUTURE
WAIVER: NO SECOND--DWELLING
APPLICANT: TEL. NO: EASEMENT: NO
SAME AS OWNER -
RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIDENI••NG;F
STATE ENCROACHMENT FERMI
CONTRACTOR: TEL. NO: \\V ----------FEES�-ID APPROVALS DATE INSPECTOR SIG TURE
SAME AS OWNER
LIC. NO FEEDESO RIPlIO N: �--OUANT�\\� AMOUNT: NEW HOUSE SEWER
01=P,ERMIv ISSUANCE FEE- 27.75 CONNECT ADDITIONAL za
1,5 ALL%REP HOUSE SEWER 1.00 EAC 30.45 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. NO: ( =T,OTAL FEES 58.20
SEPTIC TANK, SEEPAGE PIT
L � , } AND/OR DRAIN FIELD
4 irk
IC. N0: � 4 i I _ - v
�,; _ {_ �!J '' _ _i• DRYWELL
SEWER MAP BOOK: PAGE: 'rj)li /��. �j� �� // ALTER, REPAIR, SEWER OR
SEWAGE DISPOSAL SYSTEM
_ r
j DISCONNECT PLUG AND
ABANDON HOUSE SEWER
BACKFILL SEPTIC TANKS -
�� SEEP. PIT _ CESSPOOL
% GRAYWATER SYSTEM
V4
REPORT ID: DPR266 ROUTE TO BS0508