HomeMy Public PortalAbout6232 MUSCATEL AVE_Sewer__ EJa ,° 63+6A642D APPLICATION FOR PERMIT
COUNTY OF LOS ANGELES
SEINER-SEWAGE DISPOSALDEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION UILOING r �
JOHN A. LAMBIE, County Engineer
fANIAREST
caREssW ILLIAM A. JENSEN, Supt of BuildingOCAL TV
ROSS ST
-
FOR APPLICANT TO FILL IN ___--
_
DES CRI PT'ION LOT NO-. �- ,$'- -._ _ _.__ OWNER 4 ------
��- MAIL.
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$LOC:Ft l'RAL=? sx .fr: 'Cr'..
ADDRESS
- NO. Of SLOGS.
SIZE OF LOT NOW ON LOT CT-1 Y TEL. NO.
USE OF DISTRICT NO. GROUP MRPPROCESSED BY
BUILDINGS 1 _ -_ _ - BK PG %
f
CONTRACT Of
CONNECTION DATA
ADDRESS __--
0 STATION :. DEPTH
,c .. STATE MANHOLE REFERENCE
PPER
REGISTRATION NO F__`.. �-�COUNTY
NO�r-_rESC IPTION OF WORK FEE � TYPE OF CONNECTIFON -�� LENGTH"FROM •<x. T
MOUSE SEWER CONNECTING TO T-- � - Y. CURB j P.L. M.L.TO T'_L_
�' $5 00 -._T Ir �....; P.C.NO, �
PUSLI.0 SEWER JOB NO.
SEPTIC TAN}C..SEEPAGE.PPT GR ^- -'--t"- C.O. IMP. NO. !f
ITS ANO/OR DRA NF ELD $90.00
—�yHOUSE SE:W ER
—CONN-CET TO `- -- --- _ -� TRUNK,PERMIT'NO. ROAD PERMIT NO.
PRIVATE DISPOSAL SYSTEM $5..00 _ / 4
-tC0r7NECT ADDITIONAL OR - AFFIDAVIT {I WAIVER EASEMENT RECORD. INSTR,NO. DATE
WORK TO I _
OVERFLOW HOUSE
$3 b4
AGE PIT,DRAINFIE-D -.--__I L—�I _.�—..- 1111 EXTN CESSPOOL,DRYWELL,MANHOLE 0 $5.00
I _` _
__ ---.___r HWY. OR ST.WIDENING .�.9
ALTER,REPAIR OR A.BA ANE IN H6USE
SEW Est OR DISPOSAL.SYSTEM � 88.00 ! I __�--�..___._.
�-_ STATE EN CROACH!.tENT
T PERMIT NO.
INDUSTRIAL
WASTEAPPROVAL
CHARGES
'�y�OWMEER'.{S+ �i _PER_M_IT2 00
AV 1HOWZAAIO1�6 TOTAL FEE CONNECTION CHARGE FEE
f
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON- REIMBURSEMENT FEE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXtSYING DWELLING ---- --
TO THE PUBLIC APPROVALS 1.
DATE:. I INSPEC`YOW S SIGNATURE
SIGNED TH I S_y.. DAY O l rt-.. _..- —
OVlNER OR I NEW HOUSE SEWER 1. - -----
OWNERS AGENT `' r� CONNECT
_. e.__�v�-..- _ .._.r - GONNEC.T:ADDITIONAL
BUILDING OR WORK.
ADDRESS. - ---. —.-_ _.._____1.___.-----�..___..___._.__-_-_____.._..
____ __ -_-._ - --_— ---._ SEPTIC TANK.BEEP,PMS)
�
1 HFRcBY A.KNOWLEDGE THAT I HAVE READ THIS APPLICATION AND/OR D•RAINFIEL.D
AND STATE THAT THE ,SBOVE IS CORRECT AND AGREE TO COMPLY
WITH A.LI_. COUNT"' CP.D IN.ANCES AND STATE LAWS REGULATING ,.... I.
PLUMBING AND SEWERS. CESSPOOL L-� DRYVlE LL ❑
I HEREBY CERTIFY Tt4"AT I AM PROPERLY REGISTERED AND/OR ALTER REPAIR,SEWER OR � I
L IC E"'SED AS Rt OUtRECI: BY LOS ANGLES COUNTY A._ND STATE OF SEWAGE DISPOSAL SYSTEM
CALIFORNIA OR THAT-A SAM THE-�EG.AL OWNER OF, ,A,.ND INTEND TO DISCONNECT PLUG AND -- - _--�
RESIDE IN, TH, t,B ftu DE5-�RJ,BEO_R£SIDENT IA.L. P,I OPEP,TY ABANDON NOUS SEWER
5`GN4TURE ,� „`� I^r�r' �. I P - BACKFIL 1'EPT:C TANKS ❑
OF PERMITTEE/e, . / s _ .. _f`✓ - --_ cc -T
y'- S EP PITS) CESSPOOLS �. I
VALIDATION ' ROBERT A. WOOD
SUPERVISING MECHA.NIC.AL. ENGINEER
CK. M.0 �CASH
COUNTY•OF.LOS ANGELES TEMPLE CITY # 0508 SE RMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS 89901 0003
•BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: SEWER SEPTIC: S DI G ADDR SS:---
TR: 5904 LT: 5 UN: .002 EXIST OCC GRP: IGAB-CA79T7752627
232 MUSCATEL ppV-N'
BLDGS. NOW ON LOT:
ASSESSOR INFORMATION NUMUR: CONNECTION TYPE: NEAREST CROSS STREET:
5386-010-011 ORIGINATION: THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
LENGTH ML TO PL: STATION: DEPTH:
TENANT: MANHOLE REFERENCE: UPPER/LOWER: ISSUED ON: PROCESSED B : EXPIRES ON:
01/21/99 UT 01/21/00
COUNTY IMPROVEMENT NUMBER:
OWNER: TEL. NO: PLAN CHECK NUMBER: FINAL DATE FINAL BY: CODE:
YIN SHAO-CHENG;HUANG LU-YEE - JOB NUMBER: ��/-/a
6232 MUSCATEL AV TRUNK PERMIT NUMBER: Gt �-ll
SGAB 917752627 ROAD PERMIT NUMBER: E R T-IO F WOR - -�
AFFADAVIT: NO CM.N.NECT NEw_ADDI-TIUN-T8-9EWER--
WAIVER: NO
APPLICANT: TEL. O: EASEMENT: NO
KWOK (323) 728-4833-
109 E. FLORAL DR. RECORD INSTRUMENT NBR: RECORD DATE: SPECIAL CONDITIONS:
MONTEREY PARK, CA HIGHWAY/STR aFLRG
STATE EI RSCtM�T�UMIma R�
CONTRACTOR: TEL. NO: �j �7 u \�"P D APPROVALS DATE INSPECTOR SIGNATURE
T H CONSTRUCTION (626) 573-0668-
3347 N. DELTA AVE. LIC. NO :E D TION• AUANTI • AMOUNT: NEW HOUSE SER ( l �• i /,Ae-�
ROSEMEAD, CA 91776 531397 B //
/•01 MIT SS E P E 27.75 CONNECT ADDITIONAL
/ 1 AL RHOUS R 1.00 C 30.45 BUILDING OR WORK
ARCHITECT OR ENGINEER: TEL. N0: 1 F T TAL EES 58.20
KWOK, TERENCE (323) 728-4 - S P.ICA
109 E. FLORAL DR. LIC. 1M�. AND/OR DRAIN SEEPAGEPI
FIELD
MONTEREY PARK, CA C-2479b'_ J 111111
IpJ L i DRYWELL _
SEWER MAP 8O0K: PAGE: D n n R O�f7� ALTER, REPAIR, SEWER OR
�PU IL_I� C \1V//\1V// I��Jvuu(�Lj�((� SEWAGE DISPOSAL SYSTEM
DISCONNECT PLUG AND
6 [I] � ABANDON HOUSE SEWER
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REPORT ID: DPR266 ROUTE TO BS0508