HomeMy Public PortalAbout9677 LONGDEN AVE_Sewer__ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
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DEPARTMENT -OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0012260044
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 -
PHONE: (626) 285-0488 EXT:
LEG ID: SEWER / S P IC: S BUILDING-ADDRESS:
ON FILE EXIST OCC GRP: 9677 LONGDEN AV
BLDGS. NOW ON LOT: TEMP CA 917801457
ASSESSOR INFORMATION NUMBER: CONNECTION TYPE: NEAREST CROSS STREET: KAUFFMAN
5383-019-009 ORIGINATION: THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUEU ON: PROCESSED BY: EXPIRES ON:
12/26/00 UT 06/25/01
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FIN& DAJE FINAL BY: CODE:
TEMPLE BETH DAVID (818) 287-9994- JOB NUMBER:
9677 LONGDEN AV TRUNK PERMIT NUMBER:
TEMP 917801457 ROAD PERMIT NUMBER: DESCRIPAON OF WOR
AFFADAVIT: NO REPAIR ON SITE SEWER LINE
WAIVER: NO
AP ICANT: E . NO: EASEMENT: NO
PAUL ROBERTS -
3228 ALANREED RECORD INSTRUMENT .NBR:__� RECORD DATE: SPECIAL CONDITIONS:
ROSEMEAD, CA HIGHWAY/STREE.T�WIDEN•I-NG:--
STATE ENCROACHMENT.-PERMIT-NUMBER-:%
CONTRACTOR: TEL. NO: F-EES'PAID APPROVALS DATE INSPECTOR SIGNATURE
PAUL ROBERTS (818) 798-0725-
3228 ALANREED AVENUE LIC. NO F.,EE:DESCRlPTION:,--v QUANTI Y\UDM: ;.i AMOUNT: NEW OUSE SEWER
ROSEMEAD, CA 91170 561193-C42 ' . , " - r _ \
01 PERMIT ISSUANCE FEE- -_ �• ."• 27.75 CONNECT ADDITIONAL
.15 ALT/REPdHOUSE'SEWER! -• -1.00 EAC. +, 30.45 BUILDING OR WORK 4
ARCHITECT OR ENGINEER: TEL. O: ' _ i TOTAL FEES A, �' � 58.20
SEPTIC TANK, SEEPAGE PI
LIC. NO:', _ j I ! _ I AND/OR DRAIN FIELD
! RYWELL
to
`-- _
pe= G
SEWER MAP BOOK: PAGE: ! `I r ALTER REPAIR SEWER OR
I' �� ti' '!��'( - • `� ` 4� SEWPGE DISPOSAL SYSTEM
- - - °
DISCONNECT PLUG AND
1 / — ABANDON HOUSE SEWER
RIC CFILL SEPTIC TANKS _
F ' i SEEP. PIT CESSPOOL
GRAYWATER SYSTEM
REPORT ID: DPR266 ROUTE TO BS0508
76A6420APPLICATION F R PERMIT
COUNTY OF LOS ANGELES SEWER-SEWAGE DISPOSAL
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION B:,iLD IN
JOHN A, LAMBIE, County Engineer ADDRE>s _
WILLIAM A. JENSEN, Supt of Building
LOCAL
E
ATY
NEARE
NRES
CROSS T
L
FOR APPLICANT TO FILL IN - -
_. _ MAIL � r
L_ECAL__ - i, OW NEft
MAIL
DESCRIPTION LOT NO �t
BLOCK TRACT ,` ADORE_B {
- - R - -- f d
SIZE o LOT _- 5 NOW-ON LOT .._ —__.- CITY ` L, NO.
USE-.OF
BUiLD!Nt 5 -_t OI.aTRICT N ROI. .AP PR SED BY
- 4- G `P O ES
CONTRACTP.
OR ."'..^rH '
ADDRESS CONNECTION DATA
CITY .EL. NO.
TA710N �'r_' r DEPTH
T _REGISTRATION NO _ v COUNTY MANHOLE REFERENCE _ 3� - ER R--
NO. DESCR 1 PTI N OF WO '+C IEE TYPE OF CONNECTION -_-- LENGTH FROMHOUSE: EWER CONNECTING O�_-- --� - T - --� l'�s CI.RB P.L- M.L
PUBt IC SEN E R $5 06
-.� - __ -__-.- --__ -� ..— .__--.. P.C.NO -
SEPTIC TANK.SEEPA L PIT OR. _ O
PTS ANC :OR DRA'NFIF_LD @ $10.00 Co. IMP NO. " JOB NO
PJNECSEWER Y`G TO a TRUNK PERMIT
CRMI IT NO. [ -ROAD PERMIT NO.RIVATE DISPOSAL C .00
NAIVEGTASEMENT FECORL.INSTTNO.
DATE.ONABLU OR PA3'
WORK TO HOUSE SEWER @
OVFRr LO\N SF FPA F P11 DRAINF D
-ESSPO L.URYVl EL L,MA NNO LE @ $5.06
HWY.OR ST.WIDENING
4LT E.fY RE3--AIR OR ABANDON HOUSE
--__
F" -OR'DISPOSAL 5 STEM 53.s3.00
-_. ... -... .-..-. !- - STATE ENCROACHMENT
PERMIT NO r
INDU..TRIAL,
WASTE APPROVAL
-CHARGES
OWNER'S PERMIT ap _._ _
•. _ {.. CONNECTION CHARGE f--EE
AU'T'HORIZATION TOTAL FEE -__- _- __--------__------___-- ------
I HAVE AT THIS DATE. A. CONTRACT WITH THE HEREIN "fMED CON- REIMBURSEMENT FEE
TRACTOR TOCONNECT THE ABOVE DESCRIBED EXISTING DWELLING �._._.___.__.�
TO TH,c PU BLS_ ,EW'ER_ APPROVALS I DATE INSPECTOR'S SIGNATURE
Si G.NED THIS.__DAY Oh` v 99---- ._---- ._--- - ---- ----�- ------- _._..-- --._-------
OWNCR OR NEW HOUSE SEWER � -
CW'iFR5 .CONNECT ADDITIONAL
BU DING OR WORK f
ADDRESS _-
-- --- -- -� ---- - - -- ;C TANK SEEP,PIT S)
SEPT;C ! _— _--
1 HEREBY ACKNOWILE GE. T AT t HAVE READ THIS A PL.T AT'ON �
AtiD STA7f THAT THF gOVC IS ')PRFCT AND AGR 'O GOMPLI' AND/IR GRAINFIELD
WITH ALL COUNTY O DI NA.FES AND STATE L..4 REGULATING
PLUMSING AND SEWERS CESSPOOL DRYWELL. 0
I HEREBY CERTIFY T AT AM PROPERLY RE ERE AND/ ALTER,REPAIR,SEWER OR �
L.CE
N'ED' AS B' ANGLES COUN Y A. _;TATE SEWAGE.DISPOSAL SYSTEM
i
<.+,L!FORNtA THAT I L WNER A I TEND DISCONNECT PL G RND
RESIDE IM. .aE ABOVE S I 5!_ NT E ?' A GANRON HOUSE SEWER -
SIGNATURE BACKFILLS EPTIC TANKS
OFPERNITT _.- _ _ - - -- SEEP.PI fS) CESSPOOLS ❑�
VALIDATION ROBERT A. WOOD
SUPERVISING MECHANICAL, ENGINEER