HomeMy Public PortalAbout9647 LAS TUNAS DR_Sewer__ 6A64 2D APPLICATION FOR PERMIT
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COUNTY OF LOS ANGELES SEWER—SEWAGE DISPOSAL
F DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A. LAMBYE, County Engineer DDR ss -
WILLIAM A. JENSEN. Supt of Building
LOCAL TY
NEARE
FOR APPLICANT TOlnln IN CROSS�SF
LEG 5 f t
6 ESCR7F 'DPI LOT N WNER f. [ ,,. F... f1';
MAIL
BLOCK r'RACT ADDRESS
NO. OF BI-
DGS.
SIZE OF LOT NOW ON LOT CITY TEL. NO.
USE OF
B.0 ILr IN GSk L,< __ _ __ _ _- DISTRICT NO- GROUP B.K MAP PG PROCESSED BY
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CONTRACTOR —s _.E`. k L f` �� rd f �+--✓ •_ �-S.
ADDRL s � ,. _ .�F`. �+, __---CONNECTION DATR
h .� :p F d .STATION �+� DFPTI1
CITE-�'Y - -.-{�_.1 TEL. NO. �,. f
RF_G iSI RATION*N0. 4 1 4 - Q- COUNTY MANHOLE REFERENCE ti UPPER
- -
NO I DEs,CRIN IPT�OOF WOR}` FEE TYPE OF CONNErTiQN LENGTH FROM _-----
HOUSE SEW N R CONNF_CTINCx TO 77 ? Y' CURB_ P2 L, y^_ M.L.TO PAl
I PUBLIC FEWER @ $5 00 --`— -.-- ----_.___ __ >
__--__ r _
P.C.NO.
SEPTIC'TANM SEEPAGE PIT-OR O.IMP N 0 - JOB NO.
PIT AND/OR rRAIN€-IELD ' %1000
TR _R.110. ae` ROAD PERMIT NO,
PR PATE DISPOSAL SYSTEM @ 33.00 I .P ( „
~CONNECT ADDITIONAL BLDG-..OR .y �.. AFFIDAVIT WAIY[R r EASCM CN Ri.?�.±NSTR.NO. DATE
r WORK TO.MOUSE SEWER '
__— _ ____.._..._" $3.--
OA EN FG 5 POOL.DRYWELDL,MANHOLE 4 $5.00 HWY. OR ST
° d�
ALTER,REPAIR ORABANDONHOUSE - WID�.N+NG ddb
5EWER ORDISPOS"AL SYSTEM @ $9_00_, ' ----___ .._._—___—._—_.—_.___.__-____—_.—.__-
t ---- ,___.— 5'1.4TE EN_ROACH MENT
11 PERMIT NO. -�
INDUSTRIAL
WASTE APPROVAL
CHARGES
OWNER'S PERT/IIT 21 o®_ — ---- -- - ---- -- - -----
AUTHORI ATION TOTAL FEE _ �NNECTION CHARGE FEE
'I HAVE AT THIS DATE A CONTRACT' WITH TH,' HEREIN NAMED CON.. REIMBtJRSEM€.NT FEE
TRACTOR TO CON NECT THE ABOVE DESCRIBED EXISTING DWELLING. �y E ______..Y—..__--_--______—_._._._------
•
O THE '• SL-IC S'.E'WER. APPROVALS DATE INSPECTOR'S SIGNATURE
SIGNED THIS—DAY LTi---------_.—. 19._ ------------- ----�------j----..._.-----__.---
OWNER OR NEW HOUSE SEWER
OWNERS I'OENi.— CONNECT ADOi'TIONAL
BJ;LD.ING OR WORK
ADORES,- —
-- - - _-- - - --'- --- --- --' ---- --- SEPTIC TANK.SEEP,PIT(5)
' HF . b A% KN WLEDCE THAT I HAVE READ THIS APPLICATION a
AND TATE THAT - E ABOVE i5 CORRECT AND AGREE 70 COM PL'i
AND,OR DRA3NFIELD
__.—_______ ___,—,_
Wi-H ALL COUNTY OROINANGES AND STATE LAWS REGULATING.
PLU h1
131 NG AND SEWERS CESSPOOL
El 'DRYW£LL ❑
HEREBY C5ERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR,SEWER OR---- --��----- ---_
LIC ENSF
O AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAIE DISPOSAL SYSTEM
CRLiFORNIA OR THAT 7 AM THE L.EtAI. OWNER OF. AND INTEND TO --- ----"—"------t_".___�--"'—"—'---- --
DISCONNECT PLUG AND -
RES!DE. IN, THE ABO�L:E"AF'.zGR1�ED RESIDEN-ri,+t PROPERTY. ABANDON HOUSE SEWER
1 •
"T —
SIGNAURE �_
BAKFiLL SEPTIC TANKS
OF PERMITTEE 3, SEEP PIT(S) L CESSPOOLS ❑I
—`'u'AI,IDATION ROBERT A, WOOD
SUPERVISING MECHAN;C:AL ENGINEER
CK. M.O. CASH
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ERM'IT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS 0508 971021 02
BUILDING AND SAFETY / LAND-DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
LEGAL ID: SE : S• &Ul LG
TR: 6561 LT: 139 BL: .001 ! EXIST OCC GRP: TUNA R
BLDGS. NOW ON LOT: M CA'9178 03
ASSESSOR 0 0NUMBER: lCONNECTION TYPE: 4 C TREET: CAMELLIA
8587-020-037 ORIGINATION: rI GRID: LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: I SQ 0 PROCESSED B : EXPIRES 0 :
AMERICAN SAVINGS 10/21/97 UT 10/21/98
) COUNTY IMPROVEMENT NUMBER: I •
OWNER: TEL. NO: iPLAN CHECK NUMBER: F NAL,DATE FINAL CODE:
TORR.ANCE VICTOR J - JOB NUMBER:
400 MAIN ST ( TRUNK PERMIT NUMBER: ff L
ROAD PERMIT NUMBER: DESCRIPTION OF—WORK
AFFADAVIT: NO REPAIr SEWER AT BANK BUILDING
! WAIVER: NO II
APP TEL. NO: ! EASEMENT: NO
ROTO ROOTER (213) 268-3345-
1RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
HIGHWAY/STREET WIpENI�NG:f +
STATE ENCROAC MEN PERMIT 'UQKEER. i
CONTRACTOR:
TEL. NO: ��"' F ES PPA D APPROVALS DATE SPEC OR SIGNATURE
ROTO ROOTER SVC (800) 606-7586- '
4017 E. WHITTIER BL LIC. NO FEE DESCRIPP ON:�~OU NTI'TY.. ^® AMOUNT: E HOUS SEWER
LOS ANGELES, CA 90023 186821/C36 / �- I �0 2z-
0,1-PERMI*T�lISSUA NCE EE \ 27.75 CONN T ADDITIONAL
15 A�T REP f�OUSE SEVER 1.00\ AC '` 30.30 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. NO: TOT.L• FEES 58.05 1
S P IAC TANK, SEEPAGE PIT
LIC. N0; ! 1 AND/OR DRAIN FIELD
DRYWELL
SEWER MAP BOOK: PAGE: jF=t UK, REPAIR, SEWER OR
IJLIC (jr K ALTE
SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
�t! , i Ai! ABANDON HOUSE SEWER
BACKFILL SEPTIC TAS —
�,L� SEEP i PIT CESSPOOL
! �� �r ❑ �i1s
�;• ��� ��%
GRAYWATER SYSTEM
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REPORT ID: DPR266 ROUTE TO BS0508
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