Loading...
HomeMy Public PortalAbout9415 LEMON AVE_Sewer__ IL � •, (��G����50 INSERCTS'' =76A642DB0' APPLICATION' FOR PERMIT".:' , COUNTY OF LOS ANGELES SEWED-SEWAGE ,DISPOSAL. DEPARTMENT°OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING ADDRESS I � ' JOHN A. LAMBIE, County Engaaeer �^ WILLIAM A. JENSEN, Sup't of Building LOCALITY' NEAREST FOR APPLICANT TO FILL IN CROSS ST - J �° z LEGAL OWNER -/ DESCRIPTION •LOT NO�' '�� � , MIL r rte' ` BLOCK• TRACT (ADADRESS f� -1�1,11 NO OF BLDGS. SIZE'OF LOT NOW ON LOT CITY TEL NO' USE OF BUILDINGS DISTRICT N0. GROUP MAP P ESSED BY, ' CONTRACTOR , I BK P6-1 - ADDRE,S .-��� - CONNECTION DATA, - CITY- EL N0, l f'• 'STATION DEPTH © /J STATE MANHOLE REFERENCE,,. UPPER REGISTRATION NO. �T-' COUNTY No! DESCRIPTION OF WORK' FEE HOUSE SEWER'CONNECTING TO / PUBLIC SEWER @ $1100 _ SS TYPE OF CONNECTION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.L. M.L.•TO P.L. PITS AND/OR DRAINFIELD _@ $I.00 - OVERFLOW SEEPAGE PIT, DRAINF,IELD EXTN CESSPOOL DRYWELL @ $ 00 HOUSE SEWER CONNECTING TO 7 "'P.C NO. PRIVATE DISPOSAL SYSTEM @ 00 CO IMP N0. J JOB.NO, p: CONNECT ADDITIONAL'BL-DG OR WORK TO HOUSE SEWER @ $ 00 TRUNK PERMIT NO. ROAD PERMIT NO. V ALTR, REPAIR OR ABANDON HOUSE STATE ENCROACHMENT pq SEW ER OR DISPOSAL SYSTEM @ 00 PERMIT NO Q = INDUSTRIAL _ WASTE APPROVAL 41 _ Y CHARGES OWNER'S PERMIT $ 2 OO CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- _ TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING -- APPROVALS -/DATE •q INSPECTOR'S SIGNATURE,: TO THE PUBLIC SEWER, SIGNED THIS DAY 19= NEW HOUSE SEWER OWNER OR. r / CONNECT ADDITIONAL OWNERS AGENT -BUILDING OR WORK ADDRESS SEPTIC TANK,SEEP.PIT(S) ' AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS-,APPLICATION - AND STATE THAT THE ABOVE IS 'CORRECT AND AGREE TO COMPLY CESSPOOL [IDRYWELL ❑ 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 DISCONNECT HOUSE D - CALIFORNIA OR• THAT,+--4M THE 'LEGAL THE ABOVE DESCRIBED,RESIDENT LIP OPERTY: " BACKFILL SEPTIC TANKS ❑ SIGNATURE SEEP PIT(S), ❑ CESSPOOLS ❑ ' OF PERMITTE ®" ALIDATION ROBERT A.'WOOD „ SUPERVISING MECHANICAL'ENGINEER 8.•0. CASH - - _ _ 4 '1 0 7.0 a COUNTY OF LOS ANGELES TEMPLE CITY # 0508 CSEM50811 R PERM" DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 0005,'_190004 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEG ID: SEWER 7-SEPTIC: X BUILDING ADDRESS: ON FILE EXIST OCC GRP: ON AV BLDGS. NOW ON LOT: TEMP `91.7801303 ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: OAK 5382-010-044 ORIGINATION: i THOMAS PAGE: 596 GRID: J1 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: TENANT: MANHOLE REFERENCE: UPPER/LOWER: PROCESSED BY: XPIRE ON: 05/19/00 , UT 11/15/00 COUNTY IMPROVEMENT NUMBER: OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY: CODE: CUGNO MARY A TR MARY A CUGNO TRUST (310) 548-3631- JOB NUMBER: 1678 LARAINE Cl TRUNK PERMIT NUMBER: S'Z 3,g4o SAN PEDRO, CA ROAD PERMIT NUMBER: DE CRIP ION 0 R AFFADAVIT: NO REPLACE SEWER LINE WAIVER: NO APPLICANT: TEL. NO: EASEMENT: NO M AND K PLUMBING (310) 832-9974- 765 BASIN #B RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS: SAN PEDRO, CA HIGHWAY/STREET=WIDENING:- ;_ STATE ENCROACHMENT-PERMIT>-NUMBER., CONTRACTOR: TEL. NO: // ---4�FEES;PA`ID APPROVALS DATE INSPECTOR SIGNATURE M AND K PLUMBING (310) 832-9974 \ 765 BASIN #8 LIC. NO FEE DESCRPPTION: QUANTITY: UO AMOUNT: NEW OSE SEWER SAN PEDRO, CA 479765 01 PERMIT ISSUANCE FEE � 27.75 CONNECT ADDITIONAL 15 ALT%REPJHOUSE4SEWER '\1.00 EAC \ 30.45 BUILDING OR WORK ARCHITECT OR MINER: EL. NO: /// -�� - TOTAL FEES �� 58.20 SEPTI( TANK, SEEPAGE P TT LIC. N� AND/OR DRAIN FIELD -- ---- - -�_ DR WELL _ SEWER MAP BOOK: PAGE: �� �i I-�� ( (7C ��� �J �: j 2 Ii ALTER, REPAIR, SEWER OR I. ,,'/ SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AN -- ----- -�/7 ABANDON HOUSE SEWER �t+r BACKFILL SEPTIC TANKS O h ?,• SEEP. PIT CESSPOOL GRA WATESYSTEM 1 1 Y i REPORT ID: DPR266 ROUTE TO BS0508