HomeMy Public PortalAbout10236 LIVE OAK AVE_Sewer__ D
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APPLICATION FOR PERMIT
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• 'DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE DISPOSAL
Deportment of County Engineer p
County Of Los Angeles BUILDINADDRESSG
JOHN A LAMBIE. COUNTY ENGINEER
® CASSATT D GRIFFIN, SUPT of BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS ST.
LEGAL
DESCRIPTION LOT N0 r OWNER
BLOC ®� A9_-7.9 ' MAIL
�X , s rte .A/ ADDRESS
rE N•06 OF BLDGS CITY TEL NO
SIZE OF LOT�Q Q NOW ON LOT
BUELDFNGS DIST NO. I - GROUP MAP
BK PG
CONTRACTOR
r
CONNECTION DATA
ADDRES§ �
`��' STATION DEPTH
- CITY/ , > r TEL-NO.-
MANHOLE REFERENCE UPPER
STATE LOWER
REGISTRATION NO - ❑ COUNTY �q _
No DESCRIPTION OF WORK FEE y
TYPE of CON ECTION LEN TH FROM
HOUSE SEWER CONNECTING TO �+ Y. CURB P L M TO P
PUBLIC SEWER @ $3 50
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD @ $3 00
OVERFLOW SEEPAGE PIT,DRAINFIELD
EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO IMP. NOVV�r��- NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1 00 TRUNK PERMIT NO ROAD PERMIT NO
CONNECT ADDITIONAL BLDG OR STATE ENCROACH T
WORK TO HOUSE SEWER @ $1 00 PERMIT NO
ALTER,REPAIR OR ABANDON HOUSE INDUST
SEWER OR DISPOSAL SYSTEM @ $100 W APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER'S PERMIT $ 1 00
AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN ED APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTI
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THIS DAY 19 CONNECT ADDITIONAL
OWNER OR BUILDING OR WORK
OWNERS AGENT A SEPTIC TANK,SEEP, PIT(S)
ADDRESS AND/OR DRAINFIELD
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL❑
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR
PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI/ ROPER'TY�(W"6�A BACKFILL SEPTIC TANKSSIGNATURE 'A`/� SEEP PITS) ❑ CESSPOOLS❑OF PERMITTEE � .
JOHN A LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG. INSPECTOR
CK E! 0. ASH
LAC03 2 7 8- UCr 10 4 2.0-0
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0208200003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL C: X BUILDING ADDRESS:
ON FILE EXIST OCC GRP: 10236 LIVE OAK AV
BLDGS. NOW ON LOT: TEMP CA 917802713
ASSESSOR CONNECTION TYPE: NEAREST CROSS STREET: GRACEWOOD
8586-016-033 ORIGINATION: THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
MANHOLE REFERENCE: UPPER/LOWER: ISSUED PROCESSED R .
08/20/02 JK 02/16/03
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FTE IN BY: CODE:
HSIENTEIN PROJECT INVEST. LLC (626) 255 7858- JOB NUMBER: 02-
1100 S. SAN GAB. BL. TRUNK PERMIT NUMBER:
SAN GABRIEL, CA ROAD PERMIT NUMBER: F WORK
AFFADAVIT: NO CONNECT SFR TO SEWER
WAIVER: NO
L. EASEMENT: NO
SANYAO INTERNATIONAL (626) 446-8048-
141 E. DUARTE RD. RECORD INSTRUMENT NBR: RECORD DATE: SPEC AL CONDITIONS:
ARCADIA, CA HIGHWAY/STREET WIDENING:=
STATE ENCROACHMENT-PERMI-T-.-NUMBER`S
CONTRACTOR: TEL. NO: .%r -(EEES,P ID APPROVALS DATE INSPECTOR SIGNATURE'
KING YOUNG CONSTRUCTION (626) 286-4238 �� �� \V�
9176 LAS TUNAS DR. LIC. NO FEE DESCRIPTION: QUANTITY:�UOM\ AMOUNT: NEW
TEMPLE CITY, CA 91780 630850 B i/\ /�°'t \\�\
01 PERMIT ISSUANCE FEE \ 27.75 CONNECT ADDITIONAL
03
CONN VTO)PUBLICtSEWER 1.1.00 CON \`•\ 46.95 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. NO: /�� j--iA��� TOTAL F EES ��� � 74.70
SUNSHINE DESIGN ASSOCIATES (626) 289-6300-r ,fesSEPTIC SEEPAGE PIT
301 N. ROSEMONT BLVD LIC. NO.// ��_—=— � `1 AND/OR DRAIN FIELD
SAN GABRIEL CA 91775 630850 B'/*
bRYELL
SEWER MAP BOOK: PAGE: / ALTER PAR SEWER R
SEWAGE DISPOSAL SYSTEM
— -- - - - - -- - DISCONNECT PLUG AND
ABANDON HOUSE SEWER
BACKFILL SEPTIC TANKS
SEEP. PIT _ CESSPOOL _
* ADDITIONAL DATA ON FILE
REPORT ID: DPR266 ROUTE TO BS0508