HomeMy Public PortalAbout5755 OAK AVE_Sewer__ DEPARTMENT OF COUNTY ENGINEER SEWER-SEWAGE DISPOSAL 1
DIVISION OF BUILDING AND SAFETY PERMIT APPLICATION
` COWM OF LOS ANGELES ILDING
WILLIAM J FOX. COUNTY ENGINEER I ADDRESS / (��
F-Q& APPLICANT LL LOCALITY
BUILDING NEAREST
ADDRESS CRO 8S ST
LOCALITY DISTRICT NO SERIAL NO PERMIT NO
NEAREST A 0 / Ao2 S
CROSS ST
R EIV D BY Ready for Inspection DATE ISSUED
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OWNER
MAIL USE ZONE OCCUPANCY Bn PG
ADDRESS �_
CITY TEILNO , ,,5, L
CONTRACTO CO IMP NO
ADDRESS JOB NO
CITY TEL N TRUNK PERMIT NO
R STATE
REGISTRATION NO COUNTYn
ROAD PERMIT NO OC I@ V
LEGAL STATE ENCROACHMENT
DESCRIPTION LOT N PERMIT NO
BLOCK TRACT150 E PWAS APROVAL
SIZE OF LOT NO OF BLOBS / CHARGES
NOW ON LOT
USE OF
BUILDINGS CONNECTION CNtAkQE FEE
NO DESCRIPTION OF WORK FEE REIMBURSEMENT FE
HOUSE SEWER CONNECTING TO
PUBLIC SEWER ! 350 RECEIPT NO ATE BY
HOUSE SEWER CONNECTING TO I �z I
PRIVATE DISPOSAL SYSTEM 100
CONNECT ADDITIONAL BLDG OR EXC 1 RECORDED
WORK TO HOUSE SEWER 100 NO
ALTER OR REPAIR EXISTING TE BY
SEWER OR DISPOSAL SYSTEM 100
AND/ORNDISPOSAL ABANDON SEWER 100 CONNECTION ATA
SEPTIC TANK SEEPAGE PIT OR
F PITS AND/OR DRAINFIELD 200 STATION �i DEPTH
CESSPOOL— L C MANHOLE REFERENCE
SPECIAL CONDITIONS ONLY 200 — UPPER
TYPE OF CONNECTION LENGTH FROM
CURB --&&- M L TOP L
OWNERS PERMIT ; 1 00
AUTHORIZATION TOTAL FEE l�
1 HAVE THIS DATE CONTRACTED WITH THE HEREIN NAMED
CONTR CTOR TO C PUBLIC SEWER VE DESCRIBED EXISTING APPROVALS INSPECTO SIGNATURE DATE
DWELLSIGNED THIS --DAY OF— 19— NEW HOUSE SEWER 41
OWNER OR CONNECT ADDITIONAL
OWNERS AGENT BUILDING OR WORK
ADDRESS _ AND%OR DRAINFIELD PIT(S)
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI CESSPOOL[3DRYWELL
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS ALTER REPAIR HEWER OR _
REGULATING PLUMBING AND SEWERS SEWAGE DISPOSAL SYSTEM - -
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED DISCONNECT PLUG AND
AND/OR LICENSED AS REQUIRED LOS ANGELES COUNTY ABANDON HOUSE-SEWER
AND STATE OF CALIFORNIA TI 1 AM T GA WN
ER OF THE ABOV RI I A E BACKFILL SEPTIC TANKS
SIGNATURE SEEP PITS)❑ CESSPOOLS E]
OF PERMITT E
MINING
7GA642A 663 7/53
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 SEWER PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SE 0508 0308180001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (626) 285 0488 EXT
LEGAL ID SEWER / SEPTIC X BUILDIN
TR 6561 LT 734 EXIST OCC GRP 5755 OAK AV
BLDGS NOW ON LOT TEMP CA 917802431
ASSESSOR INFORMATION NUMBER CONNECTION TYPE NEAREST CROSS STREET LIVE OAK
8587 005 012 ORIGINATION THOMAS PAGE 596 GRID J3 LOCALITY TEMPLE CITY
LENGTH ML TO PL STATION DEPTH
TENANT MANHOLE REFERENCE UPPER/LOWER ISSUED ON PROCESSED BY EXPIRES ON
08/18/03 JK 02/14/04
COUNTY IMPROVEMENT NUMBER
OWNER TEL 0 PLAN CHECK NUMBER FIN FINAL BY CODE
FONG STUART (323) 821 3604 JOB NUMBER `� x
5755 OAK AV TRUNK PERMIT NUMBER
TEMPLE CITY 91780 ROAD PERMIT NUMBER DELS1PTION OF WORK
AFFADAVIT NO REP IR & REPLACE SEWER INE
WAIVER NO
APPLICANT TEL NO
DRAIN PATROL (909) 398 1721 EASEMENT NO
4460 BROOKS ST #E&F RECORD INSTRUMENT NBR RECORD DATE
SPECIAL CONDITTN9-
14ONTCLAIR 92718 HIGHWAY/STREET WIDENING
STATE ENCROACHMENT PERMIT NUMBER
CONTRACTOR TEE-U--- FEES PAID APPROVALS D
DRAIN PATROL (626) 246 5939
144 W POMONA AVE LIC NO FEE DESCRIPTION QUANTITY UOM AMOUNT
MONROVIA CA 91016 422136 C36 20 3
01 PERMIT ISSUANCE FEE 27 75 CONNECT ADDITIONAL
15 ALT/REP HOUSE SEWER 1 00 EAC 30 45 BUILDING OR WORK
ARCHITECT OR ENGINEER TOTAL FEES 58 20
SEPTIC T
LIC NO AND/OR DRAIN FIELD
DRYWELL
SEWAGE DISPOSAL SYSTEM
ABANDON HOUSE SEWER
BACKFILL SEPTIC TANKS
SEEP PIT CESSPOOL
REPORT ID DPR266 ROUTE TO SS0508