HomeMy Public PortalAbout5709 NOEL DR_Sewer__ 8R$6a I1 es
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B a s APPLICATION FOR PERMIT
DIVISION OF BUIIMMG AND SAFI'1'Y SEWER—SEWAGE D I S POSA L
Deposhnent of County Englmw
COuaty of LOB Angeles
JOHN A LAMBIE COUNTY ENGINEER
® CASSATT D GRIFFIN SUP T OF BUILDING
F R C T FILL IN
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ROSS s
LEGAL a •
DESCRIPTION L.71O 2 JP OWNER
BAIL
BLOCK TRACT ADDRESS
NO OF BLDGS CITY TEL NO
SIZE OF LOT NOW ON LOT
USE OF DISTRICT NO GROUP BAP
BUILDINGS BK PG
CONTRACTOR /,7.e:
(G•
ADDRESS Q CONNECTION DATA
CITY µ,I�.. TEL NO yd STATION DEPTH
OltMANHOLE REFERENCE
STATE LOW E
REGISTRATION NO /�� ❑ COUNTY
No DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO TYPE rum
LENGTH FROM
PUBLIC SEWER S 9 50 V Y UR P L M L TOP L
SEPTIC TANKSEEPAGE PIT OR
PITS AND/OR DRAINFIELD 0 $300
OVERFLOW SEEPAGE PIT DRAINFIELD P C NO
EXTN CESSPOOL DRYWELL MANHOLE ® $200 CO IMP NO z 71 JOB NO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM ® $100 TRUNK PERMIT NO ROAD PERMIT NO
CONNECT ADDITIONAL BLDG OR STATE ENCROACHMENT
WORK TO HOUSE SEWER $100 PERMIT NO
ALTER REPAIR OR ABANDON HOUSE INDUSTRIAL
SEWER OR DISPOSAL SYSTEM $1 00 WASTE APPROVAL
CHARGES
CONNECTION CHARGE FEE
OWNER S PERM S _ 1 00
AUTHORIZATION TOTAL = V,J REIMBURSEMENT FEE
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN NAMED CON APPROVALS ATE 1 PECTOR SSIGNATURE
TRACTOR TO CONNECT THE ABOVE DESCRIBED EXISTING DWELLING
TO THE PUBLIC SEWER NEW HOUSE SEWER
SIGNED THI 19 CONNECT ADDITIONAL
OWNER OR BUILDING OR WORK
OWNERS AGENT 4 SEPTIC TANK SEEP PIT(S)
ADDRES 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 DISCONNECT PLUG AND
LICENSED AS REQUIRED BY S ANGELES COUNTY AND STATE OF ABANDON HOUSE SEWER
CALIFORNIA OR THAT 1 A HE LEGAL NER OF THE ABOVE
DESCRIBED RESIDENTI P ERTY BACKFILL
SEPTIC
CESSPOOLS 0
SEEP S
R
SIGNATURE `
OF PERMITT
JOHN A LAMBIE CffUNTY ENGINEER VALIDATION ROBERT A WOOD CHIEF PLBG INSPECTOR
CmR 0 CASH
L�
.GO 0 5 OV-1 JJL 11 4 450 'n
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0308220003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
TR 6561 LT 729 BL 001 EXIST OCC GRP 5709 OAK AV i
BLDGS NOW ON LOT TEMP CA 917802431
A SES INFOR14ATION NUMBER CONNECTION TYPE NEAREST CROSS STREET LIVE OAK
8587 005 003 ORIGINATION THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY
LENGTH ML TO PL STATION DEPTH
TENANT MANHOLE REFERENCE UPPER/LOWER is PROCESSED BY EXPIRES ON
08;UED ON JK 02/18/04
COUNTY IMPROVEMENT NUMBER
OWNER TEL NO PLAN CHECK NUMBER FIKALTE F nl �SLY CODE
GOODING KENNETH B & SHARON R (626) 287 7429 JOB NUMBER ^/
5709 OAK AV TRUNK PERMIT NUMBER o r
TEMP 917802431 ROAD PERMIT NUMBER
ON Ormw-
AFFADAVIT NO CONNECT GARAGE WITH WORKSHOP, STORAGE AND BATHROOM TO SEWER
WAIVER NO LINE
APPLICANT TEE--90--
FRANK MARRONE & SONS (626) 4 2548 EASEMENT NO
44
9860 LOWER AZUSA RECORD INSTRUMENT NBR RECORD DATE SPECIAL CONDITIONS
EL MONTE 91731 HIGHWAY/STREET WIDENING
STATE ENCROACHMENT PERMIT NUMBER
CONTRACTOR TEL NO FEES PAID APPROVALS DATE INSPECTOR SIGNATURE
FRANK MARRONE AND SONS (626) 444 2544 I
9860 LOWER AZUSA RD LIC NO FEE DESCRIPTION QUANTITY UOM AMOUNT NEW HOUSE SEWER
EL MONTE, CA 91731 397884036
01 PERMIT ISSUANCE FEE 27 75 CONNECT ADDITIONAL
19 CONN ADDTNL BLDG(S) 1 00 EAC 30 45 BUILDING OR WORK 6
ARCHITECT OR ENGINEER TEL NO TOTAL FEES 58 20
R J A DESIGN (626) 705 7019 ' SEPTIC TANK MPAGE PIT
1144 N EDENFIELD AVE LIC NO AND/OR DRAIN FIELD
COVINA, CA 91722 NONE '
DRYWELL
SEWER MAP BOOK PAGE ALTER, REPAIR-IINF-dr
SEWAGE DISPOSAL SYSTEM
DISCON
ABANDON HOUSE SEWER
SEEP PIT CESSPOOL
GRAYWATER SYSTEM
REPORT ID DPR266 ROUTE TO BS0508