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HomeMy Public PortalAbout9652 1/2 LIVE OAK AVE_Sewer__ 2465 IPISERTS f CEBOBB.BD APPLICATION FOR PERMIT 1sY 7/ 1 76A642D COUNTY OF LOS ANGELES SEGE DISPOSA DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS r� J Wneer ILLIAM A. JENSEN. Sup t ofnBuild ng LOCALITY III .-. NEAREST FOR APPLICANT TO FILL IN CROSS ST. LEGAL DESCRIPTION LOT NO.1 OWNER BLOCK TRACT MAIL ADDRESS Nb.OF BLDGS. SIZE OF LOT NOW ON LOT CITY TEL. NO. USE OF �/<`"- DISTRICT NO GROUP MAP PROCES BY BUILDINGS �.J BK PG CONTRACTOR ,/7 ADDRESS CONNECTION DATA Cl •Y ^TEL.NO o. © STATION DEPTH REGISTRATION NO. / / [ICOUNTYMANHOLE REFERENCE - UPPER LOWER NO. DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER @ $3.00 TYPE CONNECTION NGTH FROM SEPTIC TANK,SEEPAGE PIT OR Y. CURB P.r M.L. PITS AND/OR DRAINFIELD @ $3.00 OVERFLOW SEEPAGE PIT, DR*HW-K-t'D _ EdE3'1C.. C99&P06+_�L @ $2.00 egg HOUSE SEWER CONNECTING TO CO. IMP. NO„� JOB NO. �� PRIVATEDISPOSAL SYSTEM @ $1.00 CONNECT ADDITIONAL BLDG.OR TRUNK PERMIT NO. ROAD PERMIT N0. � VPJ +;' p WORK TO HOUSE SEWER @ $1.00 � p U SEWER OR DISPOSAL SYSTEM R ABANDON HOUSE @ $1 00 VERMIT NOROACHMEN �p��t7 Ad CI INDUSTRIAL 0 WASTE APPROVAL CHARGES G aD y OWNERS PERMIT $ 2 00 CONNECTION CHARGE FEE f �1 AUTHORIZATION I TOTAL FEE Q REIMBURSEMENT FEE NAMED CON- TRACTOR TO CIONNECT THE ABOVE DESCRIBED EXIISTDATE A CONTRACT WITH THE IING 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. (S) ADDRESS AND/OR DRAINFIE I HEREBY ACKNOWLEDGE THAT1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CESSPOOL DRYWELL ❑ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ALTER,REP IR,SEWER OR ,V PLUMBING AND SEWERS. SEWAGE DISPOSAL SYSTEM ✓ I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR _ LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF PLUG AND DISCONNECT ABANDON HOUSE CTUSE SEWER ' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIA PROPER;y. BACKFILL SEPTIC TANKS ❑ - SIGNATURE SEEP. PIT(S) ❑ CESSPOOLS C] OF PERMITTE OF VALIDATION ROBERT A. WOOD CL M.0. CASH SUPERVISING MECHANICAL ENGINEER 3 6 1FEB 14C D 0 n ,� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0302200001 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: SE P BUILDING ADDRESS: BK: 36 PG: 15 PC: 4 EXIST OCC GRP: 9652 1/2 LIVE OAK AV BLDGS. NOW ON LOT: TEMP CA 917802522 ASSESSOR FO M 0 NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: CAMELLIA 8588-008-021 ORIGINATION: THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY LENGTH ML TO PL: STATION: DEPTH: TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED N: PROCESS BY: EXPIRES 0 : 02/20/03 JK 08/19/03 COUNTY IMPROVEMENT NUMBER: OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY: CODE: BINGLEDHINA (626) 355-6753- JOB NUMBER: 9652 1//2 LIVE OAK TRUNK PERMIT NUMBER: TEMPLE CITY 91780 ROAD PERMIT NUMBER: DESCRIPTION OF WORK AFFADAVIT: NO CONNECT HOUSE TO SEWER WAIVER: NO APPLICANT: TEL. NO: EASEMENT: NO PAUL ROBERTS (626) 798-0725- 3228 ALANREED AVENUE RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS: ROSEMEAD 91770 HIGHWAY/STREET WIDENING: STATE ENCROACHMENT PERMIT NUMBER: CONTRACTOR: TEL. NO: FEES PAID APPROVALS DATE INSPECTOR SIGNATURE PAUL ROBERTS (626) 798-0725- 3228 ALANREED AVENUE LIC. NO FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: NEW HOUSE SEWER ROSEMEAD, CA 91170 561193-C42 01 PERMIT ISSUANCE FEE 27.75 CONNECT ADDITIONAL 03 CONN TO PUBLIC SEWER 1.00 CON 46.95 BUILDING OR WORK ARCHITECT OR ENGINEER: TEL. NO: 04 TAP & SADDLE 154.00 TOTAL FEES 228.70 SEPTIC TANK, SEEPAGE PIT LIC. NO: AND/OR DRAIN FIELD DRYWELL SEWER MAP BOOK: PAGE: ALTER, REPAIR, SEWER OR SEWAGE DISPOSAL SYSTEM DISCONNECT PLUG AND / J ABANDON HOUSE SEWER BACKFILL SEPTIC TANKS _ SEEP. PIT CESSPOOL GRAYWA ER SYSTEM REPORT ID: DPR266 ROUTE TO BS0508