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HomeMy Public PortalAbout9501 LEMON AVE_Sewer__ - D S&E68APPLICATION FOR PERMIT 1 S&E DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engineer County of Los Angeles 1—. JOHN A.LAMBIE, COUNTY ENGINEERCASSATT D GRIFFIN, SUPT OF BUILDING OCALITY FOR APPLICANT TO FILL IN "ST. LEGAL DESCRIPTION LOT NO /,//�qAy pq,� /,/y n¢,�,, OWNER "•,�f 111 U �•d MAIL BLOCK TRACT ADDRESS (1,��, • N0. OF BLDGS CITY TEL N SIZE OF LOT USOFs� NOW ON LOT BLEEDINGS U �0 or^ � ya DISTRICT NO GROUP MAP CONTRACTOR 13 tA W g rz b ___T - m —S R G CONNECTION DATA ADDRESS CITY �'�'� m'T9 TEL NO A fl 71 STATION I ♦ DEPTH MANHOLE REFERENCE I p j� ❑ STATE AM LOWER REGISTRATION NO. ❑ COUNTY No DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO TYPE OF - TION LENGTH 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 TRUNK PERMIT NO ROAD PERMIT NO CONNECT ADDITIONAL BLDG OR ®.(� STATE ENCROACHMENT , WORK TO HOUSE SEWER @ $1 00 �J PERMIT NO - ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL _ SEWER OR DISPOSAL SYSTEM @ $1 00 WASTE APPROVAL ' CHARGES CONNECTION CHARGE FEE _ OWNER'S PERMIT s t 00 ® REIMBURSEMENT FEE AUTHORIZATION TOTAL FEE I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- APPROVALS _ DATE INSPECTOR SSIGNATURE TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER NEW HOUSE SEWERS SIGNED THIS DAY OF 19 CONNECT ADDITIONAL OWNER OR BUILDING OR WORK OWNERS•AGENT SEPTIC TANK,SEEP,PIT(S) ADDRESS AND/OR DRAINFIELD - I HEREBY ACKNOWLEDGE THAT IHAVE 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 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 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDE TIAL PROP RTY. _ BACKFILL SEPTIC TANKS❑ jy SEEP PIT(S) ❑ CESSPOOLS❑ SIGNATURE / o /% �� _ OF PERMITTEE � JOHN A. LAMBIE,COUNTY ENGINEER VALIDATION ROBERT A WOOD.CHIEF PLBG. INSPECTOR CK. M 0. CASH LAC0 4 5 5 CUR MAR 2 8 4 1. 0.5 0 In 7GA64ZD APPLICATION■ ��cA��®� �, FOR ■ ERM IT 5 d E-663 12.54 DMSION OF BUMDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engineer = County of Los Angeles BUILDING 6657 Temple City Blvd„ WM. J. FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Arcadia' FOR-APPLICANT TO FILL IN NEAREST Camino Real LEGCROSS ST. l DESCRAPTON L T C he �Ot en OWNERTemple City'Unified School Dist. BLOCK ' u'jTRACT anta. 1'lIll a. O. 3 Y MAIL 9516 E. Longden Ave _ ADDRESS SIZE OF LOT NOW ON LOTNO OF S None CITY Temple Cit TEL. NO AT 7- 260 USE OF BUILDINGS DISTRICT NO. I GROUP I MAP SK PG CONTRACTORM.-I C. Nottingham Co, ADDRESS' 57n 33 Ciloverl CONNECTION DATA CITY' Temple City TEL. No. AT 6-301 . STATION DEPTH ❑ STATE n - MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY - UPPER LOWER 1' TYPE OF CONNECTION LENGTH FROM NO DESCRIPTION OF WORK FEE Y. CURB P L. M L TO P L HOUSE SEWER CONNECTING TO ' _ PUBLIC SEWER Q $ 3 50 42 HOUSE-SEWER CONNECTING TO )I •P RIVATE,DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG. OR CO. IMP NO. JOB NO. WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT 1 00 PERMIT NO. SEPTIC TANK,SEEPAGE PIT OR - ITS AND/OR DRAINFIELD 2,00 INDUSTRIAL' CESSPOOL-DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES PERMIT CONNECTION CHARGE FEE OWNER'S $ t 00 AUTHORMATION - TOTAL FEE REIMBURSEMENT FEE TRACTORHAVE TTOS CONNECTDATE ONTRTHEACTED ABOVEWDESCRBED EXISTINGITH THE HEREIN A DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER - NEW HOUSE SEWER SIGNED THIS DAY OF 19- OWNER OR CONNECT ADDITIONAL - OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD y I HEREBY ACKNOWLEDGE THAT 1 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 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 PROPERTY. BACKFILL SEPTIC TANKS❑ /_/Z,5" �•/Ar� J(l� Temp t nM d School DTist, SEEP. PIT(3 ❑ cessPooLs SIGNATURE -�j,�/.>) Bus.14g„s OF PERMITTEE �w '�•1� _ WILLIAM J:FOX, COUNTY ENGINEERVALIDATION 1. 6 7:9 JA 14 9 S 4 �.. BY BY DEPUTY - DEPUTY BY BY - ^, ® DEPUTY PUTY &E-6D89 11.58 8 APPLICATION FOR PERMIT E-8 DIVISION OF BUILDING AND SAFETY SEWER-SEWAGE D ISPOSAL Department of County Engineer County Of Los Angeles BUILDING JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS_ ® CASSATT D GRIFFIN, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL, IN CROSS ST. LEGAL OWNER DESCRIPTION LOT N0.� f,7 y •Zle 7 BLOCK. TRACT r �� ` � /i MAIL ' 14 `n ADDRESS i -NO OF BLDGS. - ' SIZE OF LOT NOW ON LOT - CITY TEL. NO. USE OF BUILDINGS a DISTRICT NO. GROUP MAP BK PG CONTRACTOR CONNECTION DATA ADDRESS33 / STATIONDEPTH CITY TEL. NO L+ BSR MANHOLE REFERENCE d / STATE /I/j/ LOWER REGISTRATI N0. ❑ COUNTY NO DESCRIPTION OF YO, FEE HOUSE SEWER CONNECTING TO TYPE OFC T10N LENGTH FROM �B Y- UR P L M L TO P.L. PUBLIC SEWER @ $3 SO • SEPTIC TANK,SEEPAGE PIT,OR ' PITS AND/OR DRAINFIELD @ $3 00 _ OVERFLOW SEEPAGE PIT,DRAINFIELD P C. NO. EXTN ,CESSPOOL,DRYWELL,h1ANHOLE @ $2 00 CO. IMP. NO. 10B NO. HOUSE SEWER CONNECTING TO `�gqq PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO. ROAD PERMIT NO.(,J CONNECT ADDITIONAL BLDG ORSTATE ENCROACHMENT WORK TO HOUSE SEWER @ $1 00 D PERMIT NO ALTER,REPAIR OR ABANDON HOUSE INDUSTRIAL SEWER OR DISPOSAL SYSTEM Q $1 00 WASTE APPROVAL CHARGES CONNECTION CHARGE FEE• OWNERS PERMIT $ 1 00 AUTHORIZATION TOTAL FEE JV REIMBURSEMENT FEE 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 SE .(�/ NEW HOUSE SEWER SIGNED THIS DAY O 19�(% CONNECT ADDITIONAL OWNER OR /1 BUILDING OR WORK OWNERS AGENT ^,VY SEPTIC TANK,SEEP, PITS) ADDRESS AND/OR DRAINFIELD 1 HEREBY ACKNOWLED E kHAT I HAV6 READ T PLICAT CESSPOOL❑ DRYWELL❑ AND STATE THAT THE ABOVE IS CORRECT AND AOEt TO COM 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 SAND STATE OF ABANDON HOUSE SEWER CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE S RIB RF�k� L ✓ �,PROP RTY BACKFILL SEPTIC TANKS E:1j SI A ,/ O♦ SEEP PIT(S) ❑ CESSPOOLS �Z OF PERMITTEE Of T JOHN A LAMBIE. COUNTY ENGINEER VALIDATION ROBERT A WOOD, CHIEF PLBG INSPECTOR `K4 "2 3 R JAN 3 0 4 4.5 0 CE°08 '2-68 APPLICATION FOR PERM _lCSF - 7°A 6420 COUNTY OF LOS ANGELES SEWER-SEWAG DISPOSA DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION BUILDING JOHN A. LAMBIE. COUNTY ENGINEER ADDRE58 COLEMAN W. JENKINS. SUP T OF BUILDING / LOCALITY NEAREST FOR APPLICANT TO FILL IN `ROSS ST LEGAL DEBCRI -TION LOT NO OWNER MAIL BLOCK TRACT ADDRESS ;J NO OF BLDG6 SIZE OF LOT NOW ON LOT CITY TEL NO. USE OF BUILDINGS DISTRICT NO. GROUP MAP PROCESSED BY 1 A �;?! �D/K� �P O(]/ t CONTRACTOR .S S O V 0 JY� _;:N ADDRESS , V CONNECTION DATA CITY TEL NO S STATION ©�� /.� -7, S DEPTH STATE LIC , MANHOLE REFERENCE �s', LOWER LICENSE NO CLASS �'a NO DESCRIPTION OF WORK FEE TYPE OF CONNECTION LENGTH FROM HOUSE SEWER CONNECTING TO Y CURB t MIL TOP L PUBLIC SEWER 0 $5 00 P G NO SEPTIC TANK SEEPAGE PIT OR �. I PITS AND/OR DRAINFIELD $1000 CO IMP NO JOB NO HOUSE SEWER CONNECTING TO TRUNK PERMIT NO ROAD PERMIT NO ��� PRIVATE DISPOSAL SYSTEM $300 O CONNECT ADDITIONAL BLDG OR AFFIDAVIT I wAIVER [ASEKENT RECORD INSTR NO DATE I () WORK TO HOUSE SEWER @ $300 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN CESSPOOL DRYWELL MANHOLE 1900 ALTER REPAIR OR ABANDON HOUSE HWY OR ST WIDENING I'lHCG OH Q�?J V SEWER OR DISPOSAL SYSTEM $300 STATE ENCROACHMENT d PERMIT NO INDUSTRIAL I WASTE APPROVAL `('[ OWNERS s i 00 40 CONNECTION CHARGE FEE CHARGES AUTHORIZATION[PERMIT TOTAL FEE 1HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON REIMBURSEMENT FEE TRACTOR TO-CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER APPROVALS DATE INSPECTOR'S SIGNATURE SIGNED THIS DAY OF 19_ OWNER OR NEW HOUSE SEWER •� ` OWNERS AGENT_ CONNECT ADDITIONAL ADDRESS BUILDING OR WORK SEPTIC TANK SEEP PITS) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR DRAINFIELD AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS CESSPOOL ❑ DRYWELL ❑ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR ALTER,REPAIR SEWER OR LICENSED AS REQUIRED BY LOS ANGLES COUNTY AND STATE OF SEWAGE DISPOSAL SYSTEM CALIFORNIA OR THAT I THE LEGA O NER F AND INTEND T DISCONNECT PLUG AND RESIDE IN THE ABOV D CRIBED I N AL ROPE RdY ABANDON HOUSE SEWER SIGNATURE BACKFILL SEPTIC TANKS ElOF PERMITTEE SEEP PIT(S) ❑ CESSPOOLS ❑ VALIDATION, JACK R. ALLEN CK M O CASH SUPERVISING MECHANICAL ENGINEER �C�5 41 tR ml 6 1 0 7.0 ON. s a E esD APPLICATION FOR PERMIT. DIVISION OF BUILDING AND'SAFETY SEWER—SEWAGE DISPOSAL Depo=tmen# of County Engineer County of,Los Angeles BUILD ' JOHN A. LAMBIE, COUNTY ENGINEER ADDRESS ® CASSA,D GRIFFIN, SUP T of BUILDING LOCALITY FOR APPLICANT TO FILL'IN CROSS ST. /G e uljn4i LEGAL c DESCRIPTION LOT NO. l/AwVnM ery�� Ie! �/I,�/G' �JJ� /1,4 3/ CLq.L LJf_S �+v 4 l•, ) U MAIL /� � 'A BLOCK TRACT AA����((vI�� t ADDRESS ✓� ,�/T �61E nocj , NOWOON LOTS CITY f TEL NO SIZE OF LOT USE OF �n, �^w ®O BUILDINGS •ii lr Q,�1�'{JS L-. DIST NO I GROUP - MAP BK PG CONTRACTOR _ v ADDRESS �3©O , -N CONN/E�CTION•DATA Ifl7n STA ON E 4- �S I Y DEPTH CITY TEL. N0, r /{j MANH REFERENCE O ` ❑ STATE LOWER REGISTRATION N0, ❑ COUNTYAJA 4a (&'S9� A!o Am�ON 6 No DESCRIPTION OF WORK FEE_ HOUSE SEWER CONNECTING TO TYPE OF CTI LENGTH FROM PUBLIC SEWER @ $3 50 Y. CU M L. TO P L. SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD _ Q $3 00 OVERFLOW SEEPAGE PIT, DRAINFIELD P C NO. EXTN ,CESSPOOL,DRYWELL,MANHOLE Q $2 00 CO IMP. NO. J08 NO HOUSE SEWER CONNECTING TO �. D PRIVATE DISPOSAL SYSTEM Q $1 00 TRUNK PERMIT NO ROAD PERMIT NO 9 _ CONNECT-ADDITIONALBLDG OR STATE ENCROACHMENT WORK TO HOUSE SEWER (a $1 00 ®� PERMIT NO ALTER,REPAIR OR ABANDON HOUSE INDUST SEWER OR DISPOSAL SYSTEM Q $1 00 WAST PPRO L CHARG W 1 i CON ECTION CHAR FEE _ OWNER'S PERMIT $ 1 00 AUTHORIZATION TOTAL FEE REI URSEMENT FEE I HAVE AT THIS DATE-A CONTRACT WITH THE HEREIN NAMED CON- PPROVAL 4ATE INS 'S SIG ATURE , TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING TO THE PUBLIC SEWER. NEW H USE SEWER _ SIGNED THIS DAY OF 19 CONNEC DDITIONAL OWNER OR BUILDING - K- OWNERS AGENT SEPTIC TANK,SEEP,PI S), ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWEL ❑ AND STATE THAT THE ABOVE IS 'CORRECT AND'AGREE TO COMPLY Am w WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER 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 COU AND STATE OF ABANDON'HOI__...ER, CALIFORNIA OR THAT I ,AM THE LEGAL OW OF THE ABOVE _ DESCRIBED RESIDENT AL PROP Ejt Y. BACKFILL SEPTIC TANKS❑ SIGNATURE SEEP.PIT(S) ❑ CESSPOOLS❑ _ OF PERMITTEE JOHN A. LAMBIE, COUNTY ENGINEER VALIDATION, ROBERT A WOOD,CHIEF PLBG. INSPECTOR CK. M 0. AS to 4 - 54, 8-- NSR 4 7.00 M r E-663 12.34 D +6S8 E•8APPLICATION . FOR PERMIT 1 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Department of County Engineer County of Los Angeles BUILDING 9459 Emperor WM. J. FOX, COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAR T Oak St, LiGAL DESCRIPTION LOT N05 (The easterly 66t OWNER Temple City Unified School Dist. BLOCK TRACT 4,314• MAIL - ADDRESS 9516 E. Longden Ave SIZE OF LOT NOW ONNO OF LOT le LOTS' None CITY Tem City Y TEL No. AT 7-5268 USE OF BUILDINGS DISTRICT NO. GROUP MAP CONTRACTOR M. Q. Nottingham Co. _ BK' PG ADDRESS 5433 Cleverly - CONNECTION DATA CITY_ Temple City •TEL. NO. AT 6-3014 'STATION DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY UPPER LOWER - TYPE OF CONNECTION LENGTH FROM No, DESCRIPTION OF WORK FEE Y. CURB P.L. M L.TO P L HOUSE SEWER CONNECTING TO C _ PUBLIC SEWER @ $ 3 50 �p HOUSE SEWER CONNECTING TO Q� C ara _ PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG. OR CO. IMP. NO. JOB NO _ WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO. DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT -*"AO4 1 00 PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR _ PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL-DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES CONNECTION CHARGE FEE OWNER'S PEST s 1 00 AUTHORIZATION I TOTAL FEE REIMBURSEMENT FEEI HAVE DATE CON- TRACTORTTOS CONNECT THEA CTED ABOVEWITH DESCRBED EXISTINGTHE HEREINAMED DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THIS DAY OF 19_ OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK 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 J. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. ALTER, REPAIR, SEWER OR I H _ SEWAGE DISPOSAL SYSTEM EREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR e LICENSED,AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF DISCONNECT PLUG AND t, CALIFORNIA OR THAT I-AM THE,LEGAL OWNER- OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ y/ /-/Lj-�,, �� 'empl SCh001 D1St� SEEP. PIT(S) ❑ CESSPOOLS. SIGNATURE P,ERMETTEE o »Ov-,/Iwi Bus Mgr WILLIAM J. FOX, COUNTY ENGINEER VALIDATION BY ijy1.6 375`n-JAIL 9 8 4 BY DEPUTY DEPUTY BY BY DEPUTY f DEPUTY ¢- E-6D 6 APPLICATION.- FOR ■ 'i_RMI ■ 1 a 6a E•8MSION OF BUMDING AND SAFETY SEWER—SEWAGE DISPOSAL Deportment of County Engineer County of LOB Angeles - - BUILDING ADDRESS 9458 Emperor- WM. J. FOX, COUNTY ENGINEER , ' -CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEARESTCROSS ST. - oak LEGAL` / DESCRIPTION LOT IiOy (the ,a Ty one- OWNER Temple City Unified School Dist. BLOCK TRACT G.31G. (half) MAIL NO OF BLDGS. ADDRESS -9616 E. Lo'ngden Ave SIZE OF LOT NOW ON LOT None ' CITY Temple MY TEL. NO. AT 7-5268 USE OF BUILDINGS DISTRICT NO. I GROUP MAP BK' PG CONTRACTOR M. C. Nottingham Co, ADDRESS 5933 Cloverly - CONNECTION DATA CITY Temple City TEL. NO. AT 6-3014 STATION DEPTH _ ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY UPPER LOWER TYPE OF CONNECTION LENGTH FROM No. DESCRIPTION OF WORK FEE Y. CURB P L. M L.TO P L. •HOUSE SEWER CONNECTING TO � PUBLIC SEWER Q $ 3 50 .f A.( 6/ cr-•l HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 1.00 - 'CONNECT ADDITIONAL BLDG OR CO. IMP. NO. JOB. NO. WORK TO HOUSE SEWER - 1 00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT 1Q�6�GIi� 3.TSM- 1 00 PERMIT NO. SEPTIC TANK,SEEPAGE PIT OR •PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL ' ,CESSPOOL• DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2.00 CHARGES CONNECTION CHARGE FEE OWNERS PERMIT $ l 00 AUTHORMATION TOTAL FEE- REIMBURSEMENT FEEI HAVE �7�♦ CON TRACTORTTOS CONNECT THEDATEA ABODVEWITH DESCRIBEDTHEH EREIN EXIISTINGA DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS SEPTIC TANK, SEEP, PIT(S) AND/OR DRAINFIELD p I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ D_RYWELL❑ , 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 SEVERS. _ - 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 DISCONNECT N-HOUSE AND CALIFORNIA OR THAT I AM THE -LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. //'�,� BACKFILL SEPTIC TANKS❑ 1-12,T6/� �'dl/_-..- •-/Ii Temple��jUrni om/Y, School Rist. SEEP. PIT(S) ❑ CESSPOOLS / (�!q(jjd2f�r•�/.( SIGNATURE LL�� ''pp,T OF PERMITTEE &� Bus.Mgr WILLIAM J. FOX, COUNTY ENGINEER VALIDATION 11 6-7 6N JAN 98 4 M BY BY " DEPUTY DEPUTY BY BY 1 ® DEPUTY EPUTY 76A642D APPLICATION.,FO.,■ PERMIT 6 8 E-663 12.54 DIVISION OF BUII.DING�AND SAFETY SEWER—SEWAGE DISPOSAL Deponent of County Engineer County of Los Angeles BUILDING 9455 Emperor WM. J. FOX. COUNTY ENGINEER ADDRESS CASSATT D. GRIFFIN. SUPT OF BUILDING - LOCALITY Temple' City _ FOR APPLICANT TO FILL IN CROSS ST.NEAREST yak ,St• DESRALG IPTION LOT No. 5 ( except the easterly OWNER • Temple City Unified School Dist, BLOCK TRAI:4314 (661 #hereof) ADAIL DRESS 9516' .E. Longden-Ave. ` SIZE OF LOT NOW ONNO OF BLOTS None CITY Temple City TEL. NO AT 7-5268 USE OF BUILDINGS DISTRICT NO. GROUP I. BK MAP PG CONTRACTOR M. C. Nottingham Co. C. ADDRESS. 5933 Cloverly CONNECTION•DATA CITY Temple City TEL. N0. AT 63014 STATION DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY UPPER LOWER TYPE OF CONNECTION LENGTH FROM NO. DESCRIPTION OF WORK FEE Y. CURB P L M L.TO P L HOUSE SEWER CONNECTING TO _ PUBLIC SEWER Q $ 350 HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM 100 CONNECT ADDITIONAL BLDG OR CO. IMP. NO. JOB NO. _ WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT t�C4t�7S�A .RSLB>FC 1 00 PERMIT NO SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES PERMIT CONNECTION CHARGE FEE ` OMR'$ S 1 00 AUTHORIZATION TOTAL FEE ,REIMBURSEMENT FEE TRACTORHAVE T TO CONNEECTHIS ONTRTHEA ABOVECTED WDESCR BEDITH-THE H EXISTING NAMED DWELLING APPROVALS DATE INSPECTOR S SIGNATURE 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/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 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 1 AM THE LEGAL- OWNER OF'THE'ABOVE DESCRIBED RESIDE �POPEtTY., BACKFILL SEPTIC'TANKS❑TemplZJyyJfie,d aScc,�h�ooDl.' Dis1t. SEEP.PIT(S) ❑ CESSPOOLS SIGNATURE 11/ avan. BUs• 1�• OF PERMITTEE _ WILLIAM J:FOX, COUNTY ENGINEER VALIDATION 6BY 1 6 7 7`ZR JAN- 98 4 t1i By DEPUTY DEPUTY - �.BY BY ,'® DEPUTY DE UTY -®�� [may_ ' • ;•- PERMIT pp. ���/p� Imo■• !6&E•863 12.54 DIVISION OF BUILDING AND SAFETY S EIA/E R-�-S EWAG E DISPOSAL D'epat ent of County Engineer E county of Loa Angeles B01LDSS 521. &.9529 Lemon = 6503 T. C_ Ri WM. J. FOX, COUNTY ENGINEER ADDRESS f. CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Temple City FOR APPLICANT TO FILL IN NEAREST. T., C. Blvd, = Lemon LEGAi a ea er 6y of the southerly DESCRIPTION�$�LOST N g OWNER Temple City Vnif-i ed SC'�•riol ni S•F•, BLOCK E TRACT S'a.nta Anita Land GO. AMAIL DDRESS, 9516 E. Longden, Ave • - NO OF BLDGS. SIZE OF LOT NOW ON LOT None CITY Temple Cit TEL. N0. AT 7-r)26 USE OF BUILDINGS _ DISTRICT NO. I GROUP MAP BK PG CONTRACTOR M. C. Mottingham Coo ADDRESS 5933 Cloverly - CONNECTION DATA CITY Temple City TEL NO. AT 6-301 4 STATION DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY UPPER LOWER TYPE OF CONNECTION' LENGTH FROM NO.' DESCRIPTION OF WORK FEE Y CURB P L. M L TO P L - HOUSE SEWER CONNECTING TO ' PUBLIC SEWER - Q_$ 3.50 44 / HOUSE SEWER CONNECTING TO 0 V I _ PRIVATE DISPOSAL SYSTEM 1 00 -CONNECT ADDITIONAL BLDG. OR CO. IMP. NO. JOB NO WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO. DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT "A9i"R`5"P@?, - 1 00 PERMIT NO SEPTIC TANK,SEEPAGE PIT OR _ _ PITS AND/OR DRAINF1ELD 2 00 INDUSTRIAL CESSPOOL-DRYWELL WASTE-APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES 1 - PERMIT CONNECTION CHARGE FEE OVfTNER'S $ 1 00 AUTHORIZATION .TOTAL FEE -REIMBURSEMENT FEEIHAVE c." TRACTOR CON ECT THEDATE A ABOVECTED WDESCR BED EXIISTINGITH THE HEREIN A DWELLING APPROVALS DATE LJ GINSPECTOR'S SIGNATURE 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/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 I AM THE LEGAL OWNER OF THE ABOVE - DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ Templ n� ' - School Dist. SEEP. PIT(S) ❑- cEssPooLs� /—�a ani 1 �� SIGNATURE OF PERMITTEE �/ Vx B I WILLIAM J. FOX,COUNTY ENGINEER VAIMATION ; 1 -6 •S 0�9 -SAN 9 8 4 �- BY BY _ Y DEPUTY - DEPUTY �•BY � BY � - ''® - DEPUTY - IEP _'6 &E-8863 12.54 ■A PLICA I®N ■ OR PERMIT 1 6&E- DIVLSION OF BUILDING AND SAFETY SEWER SEWAGE DISPOSAL. Department of County Engiaeer County of Los Angeles - BUILDING WM.J. FOX, COUNTY ENGINEER ADDRESS 9511 Lpmn-n ATTR CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY Temple City, Calif. FOR APPLICANT TO FILL IN CROSS sT. Temple 'City .Blvd o LEGAL e3S er . o e eas er _ DESCRIPTION bT N0. OWNER Temple City Unified School- D BLOCK L+' TRACT Santa. Anita Land Co. MAIL 957 E. Longden Ave. ADDRESS NO OF SIZE OF LOT NOW ON LOTS- None CITY Tej'll le City TEL NO AT '7'_ 2�jg USE OF BUILDINGS DISTRICT N0. I GROUP I MAP BK _ PG CONTRACTOR M. C. Nottingham. Co. ADDRESS 5933 Cloverly / CONNECTION DATA V CITY Temple City TEL. NO. AT —3014 STATION DEPTH ❑ STATE 'MANHOLE REFERENCE REGISTRATION N0. ❑ COUNTY UPPER LOWER TYPE OF CONNECTION LENGTH FROM NO. DESCRIPTION OF WORK FEE Y. CURB P.L Al L TO P L HOUSE-SEWER CONNECTING TO PUBLIC SEWER Q $ 350 HOUSE SEWER CONNECTING TO _ _ PRIVATE DISPOSAL SYSTEM 1.00_ CONNECT ADDITIONAL BLDG. OR CO. IMP N0. JOB NO. WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING _ SEWER OR DISPOSAL SYSTEM 1 00 TRUNK PERMIT NO. ROAD PERMIT NO. DISCONNECT AND"ABANDON SEWER STATE ENCROACHMENT CAN 1.00 __ PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARGES PERMIT CONNECTION CHARGE FEE OWNER'S $ 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE TRACTORHAVE TTO CONNECTOTHEAABOVEWDESCRIBED EXIISTINGITH -THE HEREIN ADWELLIING CON- a APPROVALS (� DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER SIGNED THIS DAY OF 19_ NEW HOUSE SEWER OWNER' ' `OR,. CONNECT ADDITIONAL OWNERS AGENT BUILDING OR WORK ADDRESS - SEPTIC TANK, SEEP, PITS) - 0.ND/OR"DRAIN FIELD 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 PLUMBING AND SEWERS. ALTER, REPAIR,SEWER OR 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 1 AM THE LEGAL OWNER OF THE ABOVE - DESCRIBED RESIDENTIAL PROPERTY, BACKFILL SEPTIC TANKS❑ Temple Uni 'e -School Dist s SEEP. PITS) ❑ cEssPooLs❑ SIGNATURE �, ,� BUS. Mgr 'OF PERMITTEE � WILLIAM-J. FOX, COUNTY ENGINEER VALIDATION r 1681 98 4 _0 . ;SBY BY DEPUTY DEPUTY 4 M:BY BY _ �`® DEPUTY ITY . 7CA642DAPPLICATION .,LICA ■ ION . ■ OR \1101IT 1 •66 e}16 6&3 E E-669 12.64 DIVISION OF BUILDING AND SAFETY SEWER—SEWAGE DISPOSAL Dep. ent of County Engineer County of Los Angeles BUILDING 94x73 Lemon WM. J. FOX, COUNTY ENGINEER ADDRESS "CASSATT D. GRIFFIN, SUPT OF BUILDING - LOCALITY Temple "Cit�l, Calif FOR APPLIC T TO FILL IN CROSS ST. . Temple City Blvd. LEGAL easterly _ i Q oz e westerly DESCRIP {; LOTj'(fO. .6 - OWNERTemple ,City Unified School Distric BLOCK E TRACT Santa Anita Land. Co. n DRESS9516 E. Longden Ave. NO.OF BLDGS. SIZE OF LOT NOW ON LOT None CITY Temple City TEL. No. AT 7-5268 USE OF BUILDINGS DISTRICT NO. I GROUP I MAP BK PG CONTRACTOR M' C Nott!nuhaTn Co, ' ADDRESS 5933 Cloverly CONNECTION DATA CITY- Temple City TEL, NO. AT 6-3014 STATION DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. - ❑ COUNTY I UPPER LOWER TYPE OF CONNECTION LENGTH FROM NO. DESCRIPTION OF WORK FEE Y. CURB P L. M L.TO P L. HOUSE SEWER CONNECTING TO " _ PUBLIC SEWER @ $ 3 50 HOUSE SEWER CONNECTING TO - lvn `c PRIVATE DISPOSAL SYSTEM 1 00 _ :a ond CONNECT ADDITIONAL BLDG OR CO. IMP NO. JOB. NO. WORK TO HOUSE SEWER 1 00 ALTER OR REPAIR EXISTING -SEWER OR DISPOSAL SYSTEM 1 DO TRUNK PERMIT NO. ROAD PERMIT NO DISCON NECT AND ABANDON SEWER STATE ENCROACHMENT 9i�F6P9Gl4------ 1 00 PERMIT NO SEPTIC TANK,SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL-DRYW,ELL WASTE APPROVAL -SPECIAL CONDITIONS ONLY 2 00 CHARGES OWNER'S PERMIT _ CONNECTION CHARGE FEE - $ 1 00 AUTHORIZATION TOTAL-FEE REIMBURSEMENT FEE HAVE TN. RACTORTTOS CONNECTDATE OTHEAABODYEWDESCR BED EXITH THE ESTINGIN A DWELLMED �NG APPROVALS DATE INSPECTORS SIGNATURE TO THE PUBLIC SEWER NEW HOUSE SEWER SIGNED THIS DAY OF 19_- OWNER OR - - - CONNECT ADDITIONAL - OWNERS AGENT BUILDING OR WORK SEPTIC TANK, SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD - I HEREBY ACKNOWLEDGE THAT 1 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 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 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. BACKFILL SEPTIC TANKS❑ TEEm �,d School Dist. SEEP. PITS ❑ CESSPOOLS _ SIGNATURE OF PERMITTEE • ij.�� :r - WILLIAM J. FOX, COUNTY ENGINIEER' VALIDATION f BY LAC01 6.8. 2 JA 9 8 -4 tD By DEPUTY DEPUTY- BY By ® DEPUTY - DEPUTY r•6AE466312-54'r •4-+ Yom ■ LI VATI®N' FOR PERMIT - 1• DMSION OF BUILDING AND SAFETY S EIA/E R—S E WANG E DISPOSAL Deportment of County Engineer BUILDING a/ County of Los Angeles 0Z FAI0 /t ' WM. J. FOX, COUNTY ENGINEER ADDRESS ' CASSATT•D. GRIFFIN, SUPT OF BUILDING - LOCALITY TEMPLE CITY. CALIF FOR APPLICANT TO FILL IN NEAREST LEMON AVE. LEGAL DESCRIPTION LOT NO. OWNER TEMPLE CITY UNIFIED SCHOOL DIST.- BLOCK TRACT Ila ✓ / MAIL ADDRESS 9516 Eg Lonedon Ave, _ NO, OF BLDGS. SIZE OF LOT - NOW ON LOT CITY Tem 1e City TEL. NO USBUILDINGS School- Bldg. DISTRICT NO. GROUP MAP _ BK _ PG CONTRACTOR BURKE HOWARD ADDRESS 2436 No, Rosemead Blvd, CONNECTION DATA CITY El Monte,, Calif JEL NO. STATION .I 4V,? / DEPTH Cry 0 ❑ STATE ��/ Q� //� MANHOLE REFERENCE LOWER REGISTRATION'NO. 132546 - ❑ COUNTY V i� fl/ ° TYPE OF CONNECT70 LENGTH FROM NO. DESCRIPTION OF WORK - FEE Y• CURB P L M L.TO P L HOUSE SEWER CONNECTING TO fel I PUBLIC SEWER $ 3 50 r` HOUSE SEWER CONNECTING TO _ PRIVATE DISPOSAL SYSTEM 1 00 " CONNECT ADDITIONAL BLDG. OR CO; IMP. N0. JOB. NO WORK TO HOUSE SEWER 1 00 1 ALTER OR REPAIR EXISTING SEWER OR DISPOSAL SYSTEM 1100 TRUNK PERMIT NO. ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT / AND/OR DISPOSAL SYSTEM 1 00 PERMIT NO SEPTIC TANK, SEEPAGE PIT OR PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY 2 00 CHARG CONNECTION CHARGE E L OWNERS PERMIT $ 1 00 AUTHORIZATION TOTAL FEE• REIMBURSEMENT FEE I HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED CON- fc - TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING APPROVALS DATE INSPECTOR'S SIGNATURE TO THE PUBLIC SEWER - SIGNED THIS DAY OF 19- NEW HOUSE SEWER OWNER OR CONNECT ADDITIONAL BUILDING OR WORK OWNERS AGENT SEPTIC\TANK, SEEP, PIT(S) - ADDRESS AND/OR DRAINFIELD 1 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 LICENSED DISCONNECT PLUG AN 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 PROPERTY. BACKFILL SEPTIC TANKS❑ 1.+'1'P-H� SEEP.PIT(S) ❑ CESSPOOLS[ISIGNATURE OF PERMITTEE _ 1NILLIAM J. FOX.COUNTY ENGINEER VALIDATION + BY ° I iLV`4 489 7 , MAR27 4 7.0 0 DEPUTY DEPUTY BY BY �'® - DEPUTY DEPUTY D 6&E-663 12.34 Ap■ L VATOONV FOR PERMIT 1•8 R E-8 DMSION OF WELDING AND SAFETY SEWER—SEWAGE DISPOSAL _ Deportment of County Engineer County of Los Angeles fADDRE G 9/x.5 Emperor WM.J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN,SUPT OF BUILDINGY Temple City 212111111 FOR APPLICANT TO FILL IN081: St. LEGAL .DESCRIPTION LOT NO'. o Temple CityUnified School Dist. BLOCK TRACT�,3 51 o+tithe W `S nfl 9516 E. Longden Ave. SIZE OF LOT NOWNO OONBLOTLDGS' NONEem le Celt AT 7-5268 P Y TEL NO USE OF BUILDINGS FDISTRICT GROUP MAP SK PG CONTRACTOR M.C.Nottin,gham CO.ADDRESS 5933 Cloverly CONNECTION DATA CITY Temple City TEL. NO. AT 6-3014 DEPTH ❑ STATE MANHOLE REFERENCE REGISTRATION NO. ❑ COUNTY UPPER LOWER TYPE OF CONNECTION LENGTH FROM NO. DESCRIPTION OF WORK. FEE Y. CURB P L. M L TO P L HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $ 3.50 HOUSE SEWER CONNECTING TO ® �' /�p f PRIVATE DISPOSAL SYSTEM 1 00 CONNECT ADDITIONAL BLDG. OR CO. IMP. NO. JOB NO. WORK TO HOUSE SEWER 1.00 ALTER OR REPAIR EXISTING _ SEWER OR DISPOSAL SYSTEM 1 00 ,TRUNK PERMIT NO ROAD PERMIT NO DISCONNECT AND ABANDON SEWER STATE ENCROACHMENT '+' 1 00 PERMIT NO. SEPTIC TANK, SEEPAGE PIT OR _ PITS AND/OR DRAINFIELD 2 00 INDUSTRIAL CESSPOOL- DRYWELL WASTE APPROVAL SPECIAL CONDITIONS ONLY' 2 00 CHARGES CONNECTION CHARGE FEE OWNER'S PERMIT $ 1 00 AUTHORIZATION TOTAL FEE REIMBURSEMENT FEE ( TRACTORHAVE TTOSCONNECT OTHEAABOVECTED WDESCR BED EXISTINGITH THE HEREIN ADWELLING APPROVALS DATE INSPECTOR S SIGNATURE TO THE,PUBLIC SEWER 'NEW HOUSE SEWER 1 SIGNED THIS DAY OF 19— g OWNER OR CONNECT ADDITIONAL 1\j OWNERS AGENT BUILDING OR WORK SEPTIC TANK,SEEP, PIT(S) ADDRESS AND/OR DRAINFIELD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CESSPOOL❑ DRYWELL ElAND 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 S CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE ABANDON HOUSE SEWER DESCRIBED R (DENT ALP OPERTY.•_ BACKFILL SEPTIC TANKS❑ / p emp fied School Dist SEEP. PIT-(S) ❑ CESSP"LS SIOF PERMITTEE, - %� T•' �GNATUR Bus.I��1' WILLIAM J. FOX, COUNTY ENGINEER VALIDATION ,,BY L 1BY6 7 8ZN0 JAN 98 4 � DEPUTY • DEPUTY .`BY BY E . „'® DEPUTY / D UTY