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HomeMy Public PortalAbout9421 LIVE OAK AVE_Sewer__ -61 76A6423-61 APPLICATION FOR PERMIT 6A842 COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DMSION BUILDING JOHN A, LAMBIE, CouatY Engin�e� ADDRESS r GZ WILLIAM R IENSEN, Supt of Building I _ LOCALITY NEAREST FOR APPLICANT TO FJLL IN A CROSS ST. LEGAL 'C./ OWNER DESCRIPTION LOT N0. J ) BLOCK TACTMAIL aJ 7g Z ADDRESS 0.OF BLDGS. SIZE OF LOT NOW ON LOT CITY / TEL. NO .� USE OF BUILDINGS � � Q DISTRICT N0. GROUP MAP ZROSED Y BKCONTACTORADDRESS ONNECTION D TA CITY / TEL.N0. STATION J DEPTH STATE MANHOLE REFERENCE P REGISTRATION NO. COUNTY NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 TYPE OF ION LENGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. A CURB I P.L. PITS AND/OR DRAINFIELD @ 33.00 OVERFLOW SEEPAGE PIT.DRAINFIELD } EXTN. CESSPOOL DRYWELL @ $2.00 CL HOUSE SEWER CONNECTING TO P.C.NO. Q PRIVATE DISPOSAL SYSTEM @ $1.00 CO.IMP. NO. JOB NO. CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT NO. WORK TO HOUSE SEWER S1 00 O SEWER OR DISPOSALABANDON SYSTEM HOUSE @ $ I 00 STATE ENCROACHMENT PERMIT NO INDUSTRIAL CL WASTE APPROVAL CL y CHARGES a_ OWNERS PERM $ 21 00 CONNECTION CHARGE FEE AUTHORIZATION TOTAL FEE J 0V REIMBURSEMENT FEE HAVE AT IS DATE A CONTRACT WITH THE HEREIN NAMED APPROVALS DATT INSPECTOR=S SIGNATURE TO THE PUBLIC SEWER. SIGNED THIS DAY OR 9-42L NEW HOUSE SEWER OWNER ORI.� /� CONNECT ADDITIONAL OWNERS AGENT d0 V�— cxj_r�A_l BUILDING OR WORK ADDRESSAND/OR DRAINFIELD SEPTIC TANK,SEEP.PIT(S) I HEREBY ACKNOWLEDGE THAT t HAVE READ THIS APPLICATION ' AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL ❑ DRYWELL El WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REPAIR,SEWER OR PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTE I HEREBY CERTIFY T T 1 AM PROS L G►STER D AND/OR DISCONNECT PLUG AND LICENSED AS REQUIR BY LOS ANGF-LES C NTY AND STATE 0 ABANDON HOUSE SEWER I s CALIFORNIA OR TH 1 AM THE L GAL ER OF E AB BACKFILL SEPTIC TANKS ❑ //�� ��./ DESCRIBED IDE Al PROPERTY. SEEP PIT(S) ITS ❑ CESSPOOLS GF 7 (/ SIGNATURE 7 F _ OF PERMI 1/ 0 ROBERT A. WOOD Cs 2.0. _!v/ SUPERVISING MECHANICAL ENGINEER COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0002040001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: SEWER / SEPTIC: SEWER BUILDING ADDRESS: TR: 6561 LT: 729 UN: .002 EXIST OCC GRP: 9421 LIVE OAK AV BLDGS. NOW ON LOT: TEMP CA 917802427 ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: TEMPLE CITY 8587-005-001 ORIGINATION: THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C LENGTH ML TO PL: STATION: DEPTH: TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED BY: EXPIRES ON: 02/04/00 VG 08/02/00 COUNTY IMPROVEMENT NUMBER: OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATEFINAL BY: CODE: MOORTHY SANJOY S;ELIZABETH A (626) 285-5683- JOB NUMBER: ' '' /\©0 9421 LIVE OAK AV TRUNK PERMIT NUMBER: ``[[ rtlA TEMP 917802427 ROAD PERMIT NUMBER: DESCRIPTION OF WORK AFFADAVIT: NO INSTALL SEWER CLEANOUT WAIVER: NO APPLICANT: TEL. NO: EASEMENT: NO GEORGE BRAZIL (310) 253-5229- RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS: HIGHWAY/STREET WIDENING: STATE ENCROACHMEN.T.PERMIT .NUMBER: CONTRACTOR: TEL. NO: FEES;PA ID APPROVALS DATE INSPECTOR SIGNATURE GEORGE BRAZIL (310) 253-5229- 3801 LENAWEE AVE LIC. NO FEE�DESCRIPTION: QUANTITY AMOUNT: NEW HOUSE SEWER CULVER CITY, CA 90232 679898 C20 * ;,' , - PERMIT ISSUANCE FEE�._� �`. 27.75 CONNECT ADDITIONAL 15 ALT/REP,,',HOUSESEWER, -'1.00 EAC + 30.45 BUILDING OR WORK ARCHITECT OR ENGINEER: TEL. NO: lj I_ -I TOTAL FEES \ 58.20 SEPTIC TANK, SEEPAGE PIT LIC. NO ____ I i - i ,.` AND/OR DRAIN FIELD �- DRYWELL SEWER MAP BOOK: PAGE: ALTER, REPAIR, SEWER OR - SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND ABANDON HOUSE SEWER .� BACKFILL SEPTIC TANKS _ SEEP. PIT CESSPOOL GRAYWATER SYSTEM a r ' * ADDITIONAL DATA ON FILE REPORT ID: DPR266 ROUTE TO BS0508