HomeMy Public PortalAbout6343 LIVIA AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER I SEWER--SEWAGE DISPOSAL
DIVISION OF BUILDING AND SAFETY i' PERMIT APPLICATION
COUNTY OF LOS ANGELES j
WILLIAM J. FOX. COUNTY ENl31NEER ��I BUILDINSSG //� Zi
ADORE7
FOR APPLICANT TO FILL/IN LOCALITYBUILDC,
NEAREST
ADDRESSING
DDREISS CROSS ST.
LOCALITY �,p ,.,6_a • & DISTRICT N0. SERIAL N0. PERMIT N0.
NEARESTA S
CROSS ST.
RECEIVED Y0 Ready for Inspection DAT ISSU
OWNER
MAIL
ADDRESS /�,.�/I/1/�s(� USE ZONE OCCUPANCY Of
BK MA PO
CITY TELAO.
CONTRACTOR M. G. Ottingham Co, of Tpfr (`; CO.IMP.NO.
ADDRESS 5933 N. CLOVERLY AVE.
JO6.N0. _
CITY T1-1%.CALIF.
1 TRUNK PERMIT NO.
STATE
REGISTRATION NO. / 7!Z e COUNTY' ROAD PERMIT NO.
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N0. PERMIT N0.
BLOCK TRACT ( INDUSTRIAL a
WASTE APPROVAL C
NO.OF BLDGS.
SIZE OF LOT NOW ON LOT CHARGES
USE OF
BUILDINGS CONNECTION CHARGE FEE
NO. DESCRIPTION OF WORK FEE
REIMBURSEMENT FEE `
HOUSE SEWER CONNECTING TO
PUBLICSEWER 1@ $ 350 RECEIPT NO. I DATE IBY
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 1.00
CONNECT ADDITIONAL BLDG.OR EX P ON RECORDED
WORK TO HOUSE SEWER 1.00
ALTER OR REPAIR EXISTING NO' DATE IBY
SEWER OR DISPOSAL SYSTEM 1.00
DISCONNECT AND ABANDON SEWER
_ AND/OR DISPOSAL SYSTEM 1 00 CONNECTION DATA
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD 2.00 STATION DEPTH
CESSPOOL—DRYWELL
SPECIAL CONDITIONS ONLY 2.00 "`°" NHO E REFERENCE
U ER LOWER
TYPE OF CONNECTI LENGTH FROM
OWNERS $ I I 00 -
Y. CURB P.L. M L.TO P.L.
PERMIT �
AUTHORIZATION I TOTAL FEE
I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED,
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING APPROVALS INSPECTOR'S SIGNATURE DATE
DWELLING TO THE PUBLIC SEWER
SIGNED THIS....................DAY OF.................-._.....-.-........19..._-- NEW HOUSE SEWER
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT__............ - BUILDING OR WORK
SEPTIC TANK,SEEP.PIT(S)
ADDRESS---- ---------------•-•........................................... ................ AND/ORDRAINFIELD
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI- CESSPOOL DRYWELL
TIfa z�
CAONAND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER,REPAIR,SEWER OR
REGULATING PLUMBING AND SEWERS. SEWAGE DISPOSAL,SYSTEM
1 HEREBY CERTIFY THAT IAM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY ABANDON HOUSE SEWER
AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWN-
ER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS[]
SIGNATURE
SEEP.PIT(S)� CESSPOOLS
''
OF PERM ITTEEC ...!-.. l- - - --•----- f
78A642D 663 1/53.9J
S&E- 6 APPLICATION FOR PERMIT
1
8&6.889 11.89 �"1 6� �iO I1 CI � E 9 9�
DIVISION OF BUILDING AND SAFETY SEWED—SEWAGE- DISPOSAL
Deportment of County Engineer
County of LOS Angeles BUILDING
JOHN A LAMBIE, COUNTY ENGINEER ADDRESS � _'Z `
® CASSATT D GRIFFIN, SUPT OF BUILDING LOCALITY C41Qe ; e e4 /
FOR APPLICANT TO FILL IN CROSS ST. �--
LEGAL OWNER y �4 OVg.DESCRIPTION LOT N0. e
MAIL
BLOCK TRACT 6' a/S� ADDRESS A4.} L
NO. OF BLDGS. s� CITY TEL NO. a m
SIZE OF LOT NOW ON LOT _
USE OF p ,/� DISTRICT NO. ROUP MAP
BUILDINGS b .� �� � � I BK PG
CONTRACTOR a
ADDRESS
CONNECTION DATA
t
' DEPTH
CITY STATION
UPPER E. A
MA E REFERENCE
C3STATE LOWER
REGISTRATION NO. ❑ COUNTY
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE OF CONNECTIO GTH FROM
PUBLIC SEWER @ $3 50 Y. CURB P L M L TO P.L
SEPTIC TANK,SEEPAGE PIT OR
PITS AND/OR DRAINFIELD @ $3 00
OVERFLOW SEEPAGE PIT, DRAINFIELD P. C NO.
EXTN ,CESSPOOL,DRYWELL,MANHOLE @ $2 00 CO IMP NO. JOB NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1 00 1 TRUNK PERMIT NO ROAD PERMIT NO.
/ CONNECT ADDITIONAL BLDG ORSTATE ENCROA MENT
WORK TO HOUSE SEWER @ $1 00 O PERMIT NO.
ALTER,REPAIR OR ABANDON HOUSE INDUSTRIA -
SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APP OVAL `
CHARGES
i
CONNECTION CHARGE FEE '
VNER'S PERMIT $ 1 00
AUTHORIZATIONTOTAL FEE 0 REIMBURSEMENT FEE owe) -4
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS DATE INSPECTOR'S SIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THIS DAY OF 19 CONNECT ADDITIONAL
OWNER OR BUILDING OR WORK 3`11
OWNERS AGENT 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR DISCONNECT PLUG AND '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL P PERTY BACKFI LL SEPTIC TANKS❑
SIGNATURESEEP PIT(S) EDCESSPOOLS❑
OF PERMITTEE
JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR
d 0 CASH '
,Co 2 1 2 4 MAR18 4 A 2.00- M
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0404070008
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
GAL ID: SE S R DRE S:
TR: 12115 LT: 7 EXIST OCC GRP: R3 6343 LIVIA AV
BLDGS. NOW ON LOT: TEMP CA 917801328
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: WOOLEY
5382-021-041 ORIGINATION: PROP THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPEL CITY
LENGTH ML TO PL: 35 STATION: 9+99 DEPTH: 6
T MANHOLE REFERENCE: 9+64 UPPER/LOWER: LOWER IS PROCESSED EXPIRES N:
04/08/04 VG 10/05/04
COUNTY IMPROVEMENT NUMBER:
OWNER: - TEL. NO: PLAN CHECK NUMBER: FI;L DATE FINAL BY: CODE:
ARMUS, PAM (626) 286-0180- JOB NUMBER:
6343 LIVIA AV TRUNK PERMIT NUMBER: 7
TEMP 917801328 ROAD PERMIT NUMBER: DESCRIPTION 0 ORS K m
AFFADAVIT: NO CONNECT EXISTING HOUSE TO PUBLIC SEWER
WAIVER: NO
APPLICANT: . NO: EASEMENT: NO
SGV UNDERGROUND (626) 286-2899-
RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIDENING:
STATE ENCROACHMENT PERMIT NUMBER:
CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
SGV UNDERGROUND (626) 446-6276-
120 E. BADILLO LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW ,HOUSE SEWEW--
COVINA CA 91723 800800C36 *
01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL
03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK
ARCHITECT R: -77-7-0:: 17 DISCON/ABANDN SEWER 1.00 SYS 30.45
TOTAL FEES 105.15 P , SEEPAGE T
LIC. NO:� AND/OR DRAIN FIELD
DRYWELL
SEWER MAP BOOK: PAGE: ALTER, REPAIR, SEWER OR
N 88 SEWAGE DISPOSAL SYSTEM
D-IS'CONNECT PLUG AND
ABANDON HOUSE SEWER
SACKFILL SEPTIC TANK - /q �-
SEEP. PIT CESSPOVLJ
GRAYWATER
* ADDITIONAL DATA ON FILE
REPORT ID: DPR266 ROUTE TO BS0508