HomeMy Public PortalAbout9168 LAS TUNAS DR_Sewer__ 76A 642D1'CE808 —•10-71 APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CR..S ST /►'G T�1
LEGAL
DESCRIPTION LOT NO OWNER L
MAIL
BLOCK TRACT ADDRESS
O OF BLDG5 .�`��,o
SIZE OF LOT OW ON LOT CITY // C TEL NO 6—a��I
USE OF
BUILDINGS DISTRICNO GROUP BN MAP ESSED BY
PG
CONTRACTOR �� 'd 9 /1-Z -
ADDRESS -7C} CONNECTION DATA
CITYTEL NO 6--0� STATII N DEPTH
STAT LICMAN OLE REFERENCE UPPER
'2- 2
LICENSE NO J CLASS LOWER
NO DESCRIPTION OF WORK FEE PE OF CONNECTION LENGTH FROM
HOUSE SEWER CONNECTING TO Y CURB P L M L TO P L
PUBLIC SEWER @ $7 00
SEPTIC SANK SEEPAGE PIT OR PC NO
PITS AND/OR DRAINFIELD @ SIO 00 CO IMP N JOB NO -
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM E3 00 TRUNK PERMIT NO ROAD PERMIT NO CL CONNECT ADDITIONAL BLDG OR AFFIDAVIT I WAIVE"I-E4SEMENT RECORD TR NO DATE OU
WORK TO HOUSE SEWER @ $300
OVERFLOW SEEPAGE PIT DRAINFIELD
E%TN CESSPOOL DRYWELL @ $5 00
8R ABANDON HOUSE O
HWY OR ST WIDENING
At 0
SEWER OR.GiG.PB6.AirG*r�EM @ $300 STATE ENCROACHMENT W
MANHOLE $7 00 PERMIT NO a
INDUSTRIAL h
WASTE APPROVAL Z
OWNERS PERMIT S s 00 CHARGES
AUTHOMATION1 TOTAL FEE CONNECTION CHARGE FEE
IHAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEW APPROVALS DATE INSPECTOR'S SIGNATURE
SIGNED THIS_-r 19
OWNER OR 6 NEW HOUSE SEWER
OWNERS AGENT CONNECT ADDITIONAL
s1
�7iy BUILDING OR WORK
ADDRESS
SEPTIC TANK SEEP PIT(S)
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND/OR DRAINFIELD
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS RE UL TING ❑
PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL
I HEREBY CERTIFY THAT I AM PROPERLY R ST ED AND/OR ALTER,REPAIR SEWER OR
LICENSED AS REQUIRED BY LO NG S UN D TATE OF SEWAGE DISPOSAL SYSTEM
CALIFORNIA OR THAT I AM T W E F NO INTEND TO DISCONNECT PLUG AND �qq
RESIDE IN THE ABOVE DES I ED SID IAL O RTY
SIGNATURE ABANDON HOUSE SEWER
/ CKFILL SEPTIC TANKS
OF PER MfTTEE � r+�"�� ❑
SE P PIT(S) ESSPOOLS ❑
VALMA I N CK M D CASH
l � '� c �� 08 3 I14AR15 1. 0 0 6.00Ncv
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0612040004
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285-0488 EXT
LEGAL ID.. SEWER / SEPTIC SEWER BUILDING ADDRESS
TR. 5905 LT. 73 EXIST OCC GRP 9168 LAS TUNAS DR
BLDGS NOW ON LOT TEMP CA 917801905
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE. NEAREST CROSS STREET LOMA
5387-017-010 ORIGINATION: THOMAS PAGE. 596 GRID: J3 LOCALITY TEMPLE CITY, C
LENGTH ML TO PL: STATION DEPTH:
TENANT. MANHOLE REFERENCE UPPER/LOWER ISSUED ON: PROCESSED BY EXPIRES ON
TREELINE REALTY 12/04/06 JK 06/02/07
COUNTY IMPROVEMENT NUMBER -
OWNER TEL NO PLAN CHEER NUMBER F7p�T
{\!' D JTJ� FIN Y: CODE
TW PROPERTY MANAGEMENT INVESTMENT (62T 656-2889- JOB NUMBER `/jll/
5546 N. ROSEMEAD BL TRUNK PERMIT NUMBER
TEMPLE CITY CA 91780 ROAD PERMIT NUMBER: DtSCRIPTIOX OF WORK
AFFADAVIT NO CONNECT BUILDING TO PUBLIC SEWER
WAIVER NO
APPLICANT: TEL NO- EASEMENT NO
KIM WONG PLUMBING, INC. (626) 286-6080-
9631 ALPACA STREET RECORD INSTRUMENT NBR RECORD DATE SPECIAL CONDITIONS
SOUTH EL MONTE HIGHWAY/STREET WIDENING
STATE ENCROACHMENT PERMIT NUMBER
CONTRACTOR: TEL NO FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
KIM WONG PLUMBING, INC (626) 448-1383-
9631 ALPACA ST LIC. NO FEE DESCRIPTION QUANTITY UOM AMOUNT NEW HOUSE SEWER
SO.EL MONTE, CA 91733 752619 HIC
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
- SEPTIC TANK, SEEPAGE PIT
LIC NO: AND/OR DRAIN FIELD
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
* ADDITIONAL DATA ON FILE
REPORT ID DPR266 ROUTE TO BS0508